Accepting primary and secondary dental insurance: 3 benefits

Accepting primary AND secondary dental insurance at your practice can feel daunting to some dental teams. We get it, dealing with Coordination of Benefits rules is a huge task. When you accept multiple insurance plans, it means you also need to navigate rules from each plan, and correctly bill the patient. Yes, you’ll need to file the insurance claims in a specific order.

However, every dental practice should be making strategic decisions to increase its revenue. If your dental office doesn’t already, consider accepting primary AND secondary insurance plans at your practice. Getting your coordination of benefits (COB) knowledge organized is possible! It brings huge benefits to your practice.

It might seem like more trouble than it’s worth, but at Dental ClaimSupport, we’ve seen dental offices grow their revenue by accepting multiple insurance plans and educating themselves on the rules of COB in order to be compliant.

In this article, you will learn how accepting primary and secondary insurance plans, and understanding COB can help your dental practice bring in more money. This knowledge will also help instill confidence in your dental team, instead of avoiding this revenue source because of the supposed “hassle.”

1. You will increase your pool of dental patients

When you decide to accept patients covered by multiple insurance plans, you become more valuable and appealing to the pool of patients who want to use all their coverage options. Some practice managers believe that accepting dual insurance is too complicated, and decline to take patients covered by more than one plan. 

By learning COB skills, your team can have the ability to accept these patients and increase your income from the additional benefits their plans allow.

Unfortunately, coordinating benefits will trigger some questions. But life is complicated too.  People have kids, get divorced, and end up being covered by multiple insurance plans. Everyone’s situation is different. 

There are plenty of people out there who have secondary insurance plans, and you may be hurting your income and patient count by excluding these people from receiving your dental care. 

2. You will be able to collect more insurance income, which means more revenue

With the right knowledge, your team may be able to collect more from carriers when patients are covered under more than one plan.

For example, the fee set by the primary PPO will limit how much you collect from a patient with one plan. You can only collect the maximum amount on the fee schedule for treatments covered by the policy. The PPO fee is the patient’s responsibility when you’re in-network. 

But there’s a gap between the PPO allowed amount and the dentist’s full fee, which is greater. 

This is your write-off for patients with one insurance policy when they’ve met their responsibility.

But a secondary plan can help you fill the gap. 

You can submit a claim to the secondary insurance provider when treatment is covered by those benefits

Here’s an example:

The patient has two plans: On the primary plan, the doctor is in-network and on the secondary plan, the doctor is out-of-network.

$1,000  total fee submitted for a crown

$   400   primary PPO allowed fee (this is the total allowed patient responsibility)

$   200  total primary paid 

$   500  total secondary paid

$   700  total paid by both plans

The patient owes $0 because the patient's total responsibility of $400 has been satisfied due to coordination of benefits by secondary. The provider write-off is $300.

The practice can keep any amount received by all plans up to the full fee submitted, which in this example reduced the provider write-off by $300. If there had been no other insurance benefits, then the provider write-off would have been $600. 

Many dental billers make the mistake of thinking the most you can collect from insurance is the amount set by your primary PPO schedule.

However, as this example shows, you can properly collect more than the PPO fee set by your PPO contract.  This is because COB rules allow your practice to keep any amount received by all plans up to the full fee submitted. 

3. Confidence in COB rules will empower you to make your practice more successful  

What if you were able to confidently explain to patients how their multiple insurance benefits worked? Imagine the confidence in your dental team that will help the dental practice become more profitable and trusted.

COB knowledge is necessary to know what to collect from insurance and from the patient and to take correct write-offs. Having too little COB knowledge costs your practice money because it leads to incorrect write-offs or misapplied credits for payments that should legitimately go to the practice.

While understanding Coordination of benefits (COB) is not easy, it makes you highly valuable to your dental practice. It helps you have good patient relationships, do accurate billing and collect more insurance payments. You’ll save time working on claims because you’ll understand the most complicated administrative task to learn.

Instead of secondary insurance being something your practice avoids, your team can embrace their newfound knowledge, and increase their revenue with the newfound confidence that comes with understanding COB rules. 

How do I go about educating my team on Coordination of Benefits?

So now that we’ve told you three reasons why accepting secondary insurance, and understanding COB can increase your practice revenue. Now, how do you educate your team on COB?

There are a few resources you can use. Obviously, if you search “Coordination of Benefits Rules” on the internet, you’re sure to get plenty of information from reputable resources. 

We also have books and webinars available that cover topics such as COB on our website. This information can make your team a force to be reckoned with. They’ll not only be able to accept secondary insurance from patients but also be able to educate patients on their own benefits, which will instill even more confidence in your team. 

To keep learning how Coordination of Benefits knowledge is valuable for your dental team, read our Learning Center article covering this topic.