How much can my dental office bill me if I have dual insurance?

I have dual insurances when I having service. Both insurances will pay 50% on the job. However, after both insurances paid the bill, I still have to pay extra. Why?


1. the cost for the job is $1150


2. due to the $50 co-payment, my 1st insurance pay 50% only on $1100, which is $550. which means I have to pay the remaining of $550.


3. now my 2nd insurance kicks in, but due to this insurance has a contract allowance, dentist charge $1150, the allowance is only for $800, therefore 2nd insurance only paid $400.


4. now the dentist stated that I still own $150 the different off $550 whcih 1st insurance remaining minus 2nd insurance paid $400.


5. when I question the dentist, they said they dont count the allowance dual to I have dual insurance.





is it right for the dentist to bill what ever he wants? both insurance claims they pay 50% but why I still have pay extra(excluding the co-payment)? Could someone give me advice?

How much can my dental office bill me if I have dual insurance?
Generally, the patient's potential liability is determined by the primary insurance.





So, your first insurance paid $550...leaving a $550 balance. That would have been yours to pay in full, but you have a secondary policy. So, whatever the secondary pays is deducted from the $550 balance.





The secondary pays $400, which still leaves another $150 due to the provider.





That's how Coordination of Benefits usually works, so I don't think that your dentist's office is trying to rip you off. It just happened to work out that your secondary paid based off an allowed amount rather than a full billed charge.
Reply:Dual insurance never accomplishes what most people hope it will - full coverage with nothing out of pocket.





Both insurance policies will ALSO have a provision in it for dual coverage. If they both pay 50%, likely the reality is, they'll each pay 25%, and YOU will end up paying 50%. If you're paying LESS than 50% (which is what both contracts say YOU have to pay), you're ahead of the game.





And the exact question - the dentist is entitled to bill you for 100% of services rendered. Technically, any insurance billing he does is a courtesy to you, it's really up to YOU to coordinate the insurance paymetns and benefits.
Reply:second ins co has a discount with dentist. this should carry over to you. this discount sounds like a kick back. insist that this discount will be used.