Posted on March 20, 2010.
How can you bill your dentist if you have dual insurance? I am having great difficulty in getting an answer that makes sense of my office biller dental care. I had dual insurance at the time, I had service. In my experience of medical billing, we have always written off anything that an insurance provider contracted stated that we had to absorb. If they had co-insurance is the EOB, then and only then, we do not bill secondary.
1) My dentist is not writing anything off the primary insurance EOB with which they are incurred. 2) The billing amount is different for the same procedures for the 2 different insurance, 3) They try to tell me that if the insurance does not have something they can charge me more than the States EOB is my responsibility ie. if insurance has not allowed an amalgam filling versus composite resin (I think it might be fraudulent, because they are a participating provider), 4) states that the website of the CDA balance billing to the tax Lowest contract, the office said 2nd check ins.
These are actually several different questions.
1. If the primary EOB states there is a cancellation, the dentist is authorized to collect the radiation of high school. Thus, they charge the full fee in secondary.
2. If, after paying the secondary, there is still an amount due, the cancellation must be removed first before billing the patient.
3. On the amalgam vs. composite: if the insurance plan pays for a cheaper alternative (amalgam), usually the dentist can charge the patient the difference between cheap stuff and the more expensive composite material. Most dental offices informing the patient of using this composite material posterior (back) teeth. Even a PPO contract allows the dentist charges for procedures not covered (such as posterior composite restorations).
4. There are literally hundreds of ways secondary insurance can coordinate benefits when a plan is primary provice PPO contract. Many dentists I know have refused to accept the secondary insurance because of the confusion of insurance companies and manage it. I do not blame them. In many cases, a dental office waiting up to six months to be paid.
Write me if you want more detailed information. It's sorta my area.
