Dual Dental Insurance Estimates Are Tricky
Dual dental insurance estimates can also be fun. And a bit of a challenge. But we definitely want to be on our game. Because we can lose a patient over a big miscalculation. And sometimes they quietly slip away. They may not even tell us they are upset. But may cancel an appointment and offer alternative reasons.
The math isn’t difficult. However, not everyone can manage it. And it’s worth the time to investigate skill sets during interviews. As we may encounter people who do not calculate percentages well. Or who just cannot get their head around the tools necessary here. And we want to know this before hire. But there’s even more to it than math.
PPO Plan or Indemnity Plan?
Contracted insurance rates through PPO dental plans are one consideration. And then we have the private insurance plans. A patient may have two PPO plans or one of each. Or they might have a savings or discount plan and a PPO plan. Clarify and confirm dental coverage first. Know what is on the table and benefits available.
Dual Dental Insurance Estimates: Non-Duplication of Benefits Clause
Identify which carrier is primary first. And then look at the secondary very closely. Is there a non-duplication of benefits clause to consider? Because if there is, there is no secondary benefit at all. And this is where mistakes and mishaps often occur. There is no point in jumping through hoops. It just doesn’t exist here. And a written pre-estimate may not consider this.
A written pre-estimate to the secondary may show benefits. And this is where it can all go bad. Patients may not believe us. This is understandable. We have a document from their insurance carrier that says one thing. Yet here we are with another version of their copay. And we may need to walk our patients through the process and math as well.
Encourage Patients To Call Secondary Carriers
This is a great learning experience for patients. Especially when we have done our best to explain to no avail. To kindly encourage a patient to call their secondary insurance carrier may help. Arm the patient with all that they need to make the call. Be sure the patient has a copy of their estimate from both insurances. And that the patient has terminology available to them.
Have the patient ask if there is a “non-duplication of benefits clause” on their policy. And encourage the patient to ask the insurance representative to explain to them what that means. It will benefit the patient to see how much energy and time this phone call takes. And will help the patient see that the estimates are not always what they seem.