If you are covered by Principal Dental PPO insurance and another carrier, it is important that your claims be submitted correctly to maximize your benefits. Most patients with dual coverage have very little out of pocket expense after both insurance companies pay their portion. You can count on the insurance experts at Sunnyvale Dental Care to submit your claims for you in a timely manner.
Having dental coverage from multiple sources can really help you achieve your dental goals. If you are in pain, unhappy with the way that your teeth look, or are having difficulty chewing Sunnyvale Dentist Dr. Gupta is here to help.
It is important to know if Principal Dental PPO insurance is your primary or secondary carrier. If your employer provides this coverage or you have purchased an individual plan it is your primary insurance. If the Principal Dental PPO insurance is provided from another source like a spouse, it would be considered a secondary plan.
In the case of children, if one parent has coverage through Principal Dental PPO insurance and the other parent has coverage from Principal Dental or a different carrier, the parent with the earliest birthday in the year (month and day) would provide primary coverage.
Insurance companies coordinate to cover their policy holder’s dental treatment. In standard coordination of benefits, if the primary company pays 80% for a tooth colored composite filling, the secondary insurance company should pick up the other 20% leaving the patient with no copay once the deductible has been met. However, if there is a non-duplication of benefits clause and both insurance plans cover tooth colored composite fillings at 80%, the secondary insurance may not pay anything.
Sunnyvale Dentist Dr. Gupta will compile a treatment plan based on your initial examination. Once treatment is complete, the Sunnyvale Dental Care insurance coordinator will submit a claim to your primary insurance company. The primary insurance company will send a payment and explanation of benefits to Sunnyvale Dental Care. We will then submit the claim to your secondary insurance company. We will inform them of what was paid by the primary insurance and they will use this information to calculate their payment.