Can one creature enjoy two dental insurances both individual joined concordia and use both of them?
My daughter has united concordia insurance near her step father and real father. Can they both be used twords her braces?
Answers:
"Leo" is right. You will have to call the company or your benefits coordinator to find out their processing policy. SOMETIMES, even though lots feel that this is illegal (including ME0, a company will earnings based on the "Benefits less benefits" clause. This scheme, if both policy say that they pay 100% (for instance) and the first one pays 100%, the second one (or the second policy from like company) will say, "Look. You already got 100% coverage, so we don't owe you any more coverage." That's a short time ago something else to look into when you call and ask someone who can give you a specific answer for your coverage.
Probably not.
It would hold to be used as a primary and secondary. UCI #1 would be the primary with UCI #2 as the lower. UCI #2 would pay any thing that UCI #1 didn't pick up as long as it wasn't above their levy schedule. That would never happen as they are operating from impossible to tell apart fee schedule.
As an example, we'll enunciate braces cost $100 a month. UCI pays the orthodontist based on a fee diary they have contracted. Let's say it's $75. UCI #1 will retribution $75, then send the Remit/Explaination of Benefits to the orthodontist.
The orthodontist would enjoy to bill UCI #2 as the secondary. They *have* to include the EOB with the claim so UCI #2 can see how much UCI #1 compensated. UCI #2 will see that the orthodontist has been rewarded at his contracted amount and will not pay above that.
If an orthodontist bills both UCI #1 and UCI #2 as primary insurance, he/she is committing insurance fraud. The insurance company *will* catch on. Chances are they will pretty promptly because it's the same company. Any dentist would be a fool to try it. They can be thrown in lock away, have their license pulled, not allowed to adopt insurance/Medicaid. Source(s): Me. I work for a dental insurance company.
it doesn't hurt to try - it may be possible to have one pay as a primary and one to cover the co-pay as a supplemental insurance - the billing dept. at the dental organization should help you
They should both cover the braces. I would telephone call the insurance company to make sure. I would think that they do because she is below both insurnace.
The above answers are good and I would simply add this:
Since the relationship is father and step-father, you will need to know which plan is primary and which is lesser. If it were a simple "mom & dad" arrangement, the person next to the earlier birthday in the year would be primary.
But surrounded by this non-traditional family other factors come into consideration, such as relatives court orders.
Once you find out who is primary, ask about the secondary's "coordination of benefits". They should be any "standard/full" or "non-duplicaton".
Since both plans are with the same company, they shold be capable of explain everything to you completely. It's a tricky situation, so make sure you know everything before you start.
The deeply best way would be to ask your dentist or orthodontist to pre-authorize the treatment. It takes more or less 30 to 45 days, but at least you would know what the braces will end up costing YOU.
Related Questions:
Answers:
"Leo" is right. You will have to call the company or your benefits coordinator to find out their processing policy. SOMETIMES, even though lots feel that this is illegal (including ME0, a company will earnings based on the "Benefits less benefits" clause. This scheme, if both policy say that they pay 100% (for instance) and the first one pays 100%, the second one (or the second policy from like company) will say, "Look. You already got 100% coverage, so we don't owe you any more coverage." That's a short time ago something else to look into when you call and ask someone who can give you a specific answer for your coverage.
Probably not.
It would hold to be used as a primary and secondary. UCI #1 would be the primary with UCI #2 as the lower. UCI #2 would pay any thing that UCI #1 didn't pick up as long as it wasn't above their levy schedule. That would never happen as they are operating from impossible to tell apart fee schedule.
As an example, we'll enunciate braces cost $100 a month. UCI pays the orthodontist based on a fee diary they have contracted. Let's say it's $75. UCI #1 will retribution $75, then send the Remit/Explaination of Benefits to the orthodontist.
The orthodontist would enjoy to bill UCI #2 as the secondary. They *have* to include the EOB with the claim so UCI #2 can see how much UCI #1 compensated. UCI #2 will see that the orthodontist has been rewarded at his contracted amount and will not pay above that.
If an orthodontist bills both UCI #1 and UCI #2 as primary insurance, he/she is committing insurance fraud. The insurance company *will* catch on. Chances are they will pretty promptly because it's the same company. Any dentist would be a fool to try it. They can be thrown in lock away, have their license pulled, not allowed to adopt insurance/Medicaid. Source(s): Me. I work for a dental insurance company.
it doesn't hurt to try - it may be possible to have one pay as a primary and one to cover the co-pay as a supplemental insurance - the billing dept. at the dental organization should help you
They should both cover the braces. I would telephone call the insurance company to make sure. I would think that they do because she is below both insurnace.
The above answers are good and I would simply add this:
Since the relationship is father and step-father, you will need to know which plan is primary and which is lesser. If it were a simple "mom & dad" arrangement, the person next to the earlier birthday in the year would be primary.
But surrounded by this non-traditional family other factors come into consideration, such as relatives court orders.
Once you find out who is primary, ask about the secondary's "coordination of benefits". They should be any "standard/full" or "non-duplicaton".
Since both plans are with the same company, they shold be capable of explain everything to you completely. It's a tricky situation, so make sure you know everything before you start.
The deeply best way would be to ask your dentist or orthodontist to pre-authorize the treatment. It takes more or less 30 to 45 days, but at least you would know what the braces will end up costing YOU.
Related Questions: