An Assignment of Benefits (AOB) is an arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a physician, hospital or wound care provider. Wound Care Concepts supplies Gentell products.
AOB forms are attached at the bottom of this page.
Nursing home residents who receive Part B wound care benefits should sign an AOB form and receive a copy of certain information. Both the AOB and the required information for residents are contained in the document attached to this FAQ.
If a resident is unable to sign the document, a nurse or other authorized representative can sign the AOB for them.
Send the AOB to:
There are three ways to send AOB forms to Gentell:
- Fax to the main number 800-840-9054
- Scan and email the attachments to Vicky at firstname.lastname@example.org .
Give the AOBs back to the your visiting Gentell clinician.
AOB Form ATTACHED BELOW