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What Is AOB In Medical Billing?

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The acronym AOB stands for Assignment of Benefit. It is a legal contract form, which is signed by patients requesting their healthcare insurance providers to directly send the reimbursement checks to the medical practice or physician, for the medical services utilized. Signing the AOB contract would simplify payment process for the patients since it permits healthcare practices to directly get paid by the patient’s insurance provider without involving the patient’s direct intervention. This enables the patients to focus on their medical treatment rather than worrying about the payment process. It also enables the medical practice to appeal claim denials and underpayments from the patient’s insurance service provider.

Important Details That Should Be a Part of The AOB Form:

There are some details that need to be filled in the Assignment of Benefits agreement. Without these details, the legal proceedings can get affected. Only a healthcare BPO that has a proper understanding of how to get the details filled can assist a healthcare practice get the AOB forms filled properly. Some of these important requirements are:

  • Accurate Personal Details

Personal details, like the exact name of the patient, the healthcare provider and the insurance provider must be filled out accurately.

  • Confirmatory Terms

The term “irrevocable” must be used in the AOB, to confirm that this contract cannot be revoked by the patient in the distant future.

  • Patient Signature

It is critical for the patients to sign the agreement to execute the contract. The billing staff must secure patient signature on the contract to ensure a smooth legal process.

Cons of AOB:

Signing the Assignment of Benefits might prove to be disadvantageous for the parties involved in the following ways:

  • Patient Loses the Power to Negotiate

Sometimes, during situations such as medical emergencies, out-of-network (OON) physicians might have to treat the patient. This would result in the medical bill exceeding the payment covered by the insurance plan. The excess medical bill would not be covered by the insurance plan, hence, becoming the responsibility of the patient to pay all costs. If patients do not sign the AOB contract, the extra amount charged on the surprise bill can be negotiated by the patient. On signing the AOB agreement, the patient loses this power to negotiate, since the contract would not require the patient’s direct involvement in the payment process.

  • Hospitals Would Choose OON

The hospitals would choose to stay out-of-network with the insurance providers to reap the benefits of obtaining full payments from the patients. Unlike the in-network physicians, the out-of-network healthcare providers do not have to maintain the standardised quality for their healthcare services rendered. In this way, the patients would no longer be able to gain the contracted network discount benefits or the quality care for the medical services utilized. The healthcare providers may take advantage of this situation to bill consumers with unnecessary treatments, tests and procedures to hike the medical fees.

  • Increases Lawsuits

Since the patients lose the power to intervene in the payment process on signing an AOB, they would be transferring certain legal rights to the healthcare providers. The patient would no longer hold the right to sue the medical practitioner. The healthcare provider would gain the power to sue the insurance provider in absence of patient knowledge. This would increase the chances of the individual patients getting dragged into lawsuits.

While signing the AOB increases payment convenience for patients, it also on the other hand causes a greater deal of inconvenience to the patient due to the lack of transparency. Therefore. it is imperative for patients to check with their insurers before signing AOB. This would ensure a frictionless execution of the insurance policy plan.

All said and done, sometimes patients find it very difficult to understand the meaning of assignment of benefits and do not know whether to commit themselves to it or not. They may sign on the dotted line only after they clearly see the benefits in doing so. Outsourcing this task to healthcare BPO can assist healthcare practices explain the benefits of signing the AOB form to patients in the most proper and assured way.