North Dakota Direct Assignment: Consent/Reassignment Form is a document used to transfer an individual’s right to receive services from a health care provider from one mayor to another. This form is used when a mayor (health plan or insurance company) wants to give another party the right to receive payments for services provided to a patient. There are two types of North Dakota Direct Assignment: Consent/Reassignment Form: a one-time Consent/Reassignment Form and a Recurring Consent/Reassignment Form. The one-time form is used when a mayor wants to transfer the rights to receive services for a specific service or for a specific date. The Recurring Consent/Reassignment Form is used when a mayor wants to transfer the rights to receive services for a period of time, such as for a certain number of services or for a certain length of time. Both forms require the signatures of both the patient and the mayor.
North Dakota Direct Assignment: Consent/Reassignment Form
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