Secondary and Supplemental Insurance Medical Billing for Dentist

As a dentist who offers treatment for sleep apnea, you provide a great service for those living with the sleep disorder. However, it does come with a certain set of challenges because you must bill the patient’s medical insurance instead of using their dental coverage. When a patient has a secondary or supplemental insurance, this further complicates medical billing for dentist. To help simplify the process, Brady Billing will help you understand the difference between the two insurances.

What is a Secondary Insurance?

In addition to a primary medical insurance, a patient may also have a secondary. This often occurs when one individual pays for coverage through their employer and their spouse pays for one as well. Both are covered under each insurance plan; however, only one can be the primary. As an example, the husband’s insurance may be considered the primary and the wife’s additional insurance plan will be the secondary.

When there are two insurances, there will need to be a coordination of benefits to determine which one will be the primary to cover a larger portion of the services. Generally, the secondary will pay a portion of the costs that were not covered by the primary insurance.

What is Supplemental Insurance?

There is another instance where a patient may have two insurances as well, which often occurs with Medicare. When Medicare is the primary insurance, a patient can choose to cover the costs not paid by the program with a supplemental insurance. Each supplemental plan will offer different coverage. For example, some may cover all the remaining costs while another will only pay 15%.

How Will I Bill for Sleep Apnea?

When treating a patient who has two insurances, such as a secondary, each one must be billed as two separate policies. Depending on the benefits of each plan, it will determine how much the patient must pay out-of-pocket and how much each insurer will reimburse for treatment. There is no standard amount that will be paid.

Even if a patient pays the deductible for the primary insurance, they may also have to pay one for the secondary as well. You will also need to get approvals for each insurance with dental medical billing. In some cases, the primary may approve the treatment while the secondary will deny it; therefore, it is essential to get the approval of both prior to providing treatment.

Although it is rare to treat a patient who has two insurances, it does occur. In the event you treat someone who has either a supplemental or secondary insurance, it is important to bill both companies to determine each insurer’s responsibility for coverage and reimbursement.

Is There Help for Medical Billing?

The process of billing multiple insurance companies can be quite complex and offers twice the potential for error. To help provide the necessary paperwork for fast approvals, Brady Billing offers the services you need. We will work with both insurance companies to ensure you are properly reimbursed while keeping the patient’s out-of-pocket cost to a minimum. Contact our office today to learn more.