Health Insurance and Dental Plan Organizations - Dentists - Assignment of Benefits and Reimbursement of Nonpreferred Providers

Patients gain clearer bills and direct payments

Beginning January 1, 2027, Maryland health insurers cannot block patients from assigning insurance payments to doctors or dentists. Dental plans cannot block assignments to dentists. Insurers and dental plans generally must honor assignments by paying nonpreferred providers directly. They may refuse when assignment notice arrives after payment to the patient, or an accidental administrative error caused that payment. They may also refuse if the patient withdraws the assignment before payment or paid the provider in full at the visit. Before care, nonpreferred doctors and dentists seeking assignments must disclose their status, estimated costs, payment terms, and any interest amount. They must warn about charges for services insurance does not cover and extra charges for covered services, called balance billing. They must document assignments using forms developed by the Maryland Insurance Commissioner; the law does not ban balance billing. When no assignment exists and the plan pays the patient, it must identify the claim, payment amount, and remaining patient responsibility. It must also tell the patient to use that money to pay the provider unless already paid in full.