More and more people today have dental insurance from two sources to help offset the cost of dental care. This is sometimes the case with children who receive insurance from both parents or for couples who carry each other on their insurance policies. Others have two jobs that each offer dental insurance. If this is the case for you it is important to know how to utilize both insurance policies.
Sunnyvale Dentist Dr. Gupta and the staff at Sunnyvale Dental Care communicate with insurance companies on a daily basis and will help you maximize your Health Net Dental PPO insurance benefits along with any additional coverage that you have.
Primary and Secondary insurance carriers work together to pay your claims. This is called coordination of benefits. Once treatment has been completed, the Sunnyvale Dental Care insurance coordinator will submit the dental claim to the primary insurance company. They will send a payment and an explanation of benefits to our office. We will then submit the claim to the secondary insurance carrier. They will want to know the amount that has already been paid by the primary insurance. This will help them determine the amount that they will cover.
How do we know if we should bill your Health Net Dental PPO insurance company first or second? Can you decide for yourself? Unfortunately you cannot, and neither can we. There are standard guidelines in the insurance industry that determines this. If you have a Health Net Dental PPO insurance policy and you are the subscriber (person purchasing insurance), this would be considered your primary coverage. A policy that you are covered by under a different subscriber would be your secondary insurance.
For many patients with dual coverage, their patient copay is very small. Depending on the treatment rendered, some have no out of pocket cost. This is especially true for patients with policies that utilize standard coordination of benefits.
If possible you will want to avoid policies with a non-duplication of benefits clause. With this type of coordination of benefits, if both policies cover procedures at the same percentage, the secondary insurance may pay nothing on the claim. Sunnyvale Dentist Dr. Gupta is a preferred provider within the Health Net Dental PPO insurance network. Please contact us to schedule your appointment.