Do you have two different dental insurance policies? If so you are very fortunate. This can greatly reduce your dental care cost. You may have an Assurant Dental PPO insurance policy through your employer and a different plan through your spouse. Or perhaps you have two employers who both provide you with dental insurance coverage. Sometimes children have dual coverage through each parent.
Sunnyvale Dentist Dr. Gupta is an Assurant Dental PPO (Preferred Provider Organization) in network dentist. He has been for many years and has agreed to follow the Assurant Dental PPO fee schedule which means lower cost for you. The insurance coordinator at Sunnyvale Dental Care will contact Assurant Dental PPO and your additional insurance carrier to determine how they will each cover your dental treatment.
If you have dental insurance coverage through your employer, this is considered your primary coverage. Any additional dental insurance plan would be considered secondary. For a couple who each have coverage for their children, the parent whose birthday occurs first in the calendar year provides primary coverage and the other parent provides secondary coverage. Coordination of benefits describes how the primary and secondary insurance companies coordinate the payment of claims. They will never pay more than the total submitted amount.
The two types of coordination of benefits are standard and non-duplication. Standard coordination of benefits is much more beneficial to you as the patient. In standard coordination of benefits if a filling is covered by Assurant Dental PPO as your primary dental insurance at 70% your secondary insurance plan would cover the remaining 30%. If you have non-duplication coordination of benefits and Assurant Dental PPO and your secondary insurance both cover fillings at 80%, after the primary pays it’s 80% the secondary insurance will pay no additional amount. The remaining 20% of the bill would be your responsibility.
Neither you as the patient, nor the Sunnyvale Dental Care insurance coordinator can choose in which order to bill each insurance company. Sunnyvale Dentist Dr. Gupta will have his team submit your dental claim first to your primary insurance carrier and once they have paid their portion a secondary claim will be submitted. If you have an out of pocket cost it will be determined after the secondary claim has been processed.