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Is it legal for a dental insurance company to deny coverage as a secondary provider?
Yes, it can be and no it may not be. You did not give enough information for a determination.
Usually, the primary carrier pays their maximum, then the secondary carrier pays some or all of the portion of the procedure that is left BUT not more than the claim itself or more than they would have paid if their contract was primary.
Here are some reasons why it could be legitimate to deny your claim. You could have hit the limits of the secondary policy. There could be a provision in the secondary policy that it does not cover the procedure that you had or that says it does not pay anything if it is secondary. The latter is somewhat unusual but worth checking for.
Did you ask the carrier why they denied it? If they do not point to a specific provision in your contract, ask them to. If they do not, your state Insurance Department should have a consumer representative that you can ask for help in determining whether it was legitimate for them to deny coverage.
What else can I help you with?
Can the secondary insurance provider deny a claim that was not filed with the primary insurance provider first?
Let me tell you what happend to me. I hope that this helps. I used to be covered by two insurance companies. My primary insurance company was through the company that I worked with. My secondary was with the company that my husband works with. When a claim was filed with my secondary insurance company they wanted to know how much my primary insurance company paid for and until then they would not pay anything. So I had to submit to my primary insurance company and once they paid some then the secondary would. I hope that this helped:) * Yes. A claim must always be made with the primary insurer first.
What are the coverage options for medical insurance for surgery?
Coverage options for medical insurance for surgery typically include in-network and out-of-network coverage. In-network coverage means the surgery is performed by a healthcare provider within the insurance company's network, usually resulting in lower out-of-pocket costs for the insured individual. Out-of-network coverage allows the insured individual to choose a healthcare provider outside of the insurance company's network, but may result in higher out-of-pocket costs. It is important to review your insurance policy to understand the specific coverage options for surgery.
What happens when a provider fails to obtain precertification?
If a provider fails to obtain precertification for a medical service, the insurance company may deny coverage and the patient may be responsible for the full cost of the service. This can result in financial burden for the patient and could lead to disputes between the provider, patient, and insurance company. It is important for providers to follow insurance company guidelines and obtain precertification to ensure proper coverage for their patients.
How use dental insurance dental office?
Coverage for dental implants varies from one insurance company to another. Most of the insurance policies provide some coverage for the restorative procedure. You can ask your insurance provider if dental implants are covered or not.
Can I get a list of companies which are giving Boiler Insurance in US?
Any company that writes Commercial Insurance can write boiler and machinary coverage. Farmers Insurance is a large provider.
Whose insurance company pays if you let your friend borrow your car and they hit a deer with it?
The insurance follows the vehicle so your own insurance company would be primary. However, if you don't carry the comprehensive coverage on your own policy and your friend has a vehicle with comprehensive coverage, his coverage would be secondary and pay for the damages.
What kind of coverage would you get with general insurance?
This varies from provider to provider but most provide basic healthcare and dental coverage for the applicant. To see the fine print, read through different company's policys.
Can your employer ask for your vehicle insurance to drive their vehicle?
Your personal auto coverage will not cover their vehicles. What they are probably asking for is to make sure you have coverage in case you drive your vehicle on errands or such for the company. If you go to the post office to get the company mail your personal auto insurance will be the primary insurance and then if they have an endorsement to their insurance called "hired and non-owned auto" it will provide secondary coverage over and above your coverage to protect them in case of an accident. Their coverage insists that you as the employee have primary insurance on your vehicle. Also note that the company insurance will not pay for damage to your vehicle.
What type of company is Complete Coverage Insurance?
Complete Coverage Insurance is the type of company referred to as an independent insurance agency. They provide insurance coverage for automobile, home, health, business and life.
What is a combined life insurance company?
Combined Insurance is a global provider of supplemental insurance, including accident insurance, life insurance and critical care coverage. Combined Insurance operates in North America, Latin America, Europe and the Pacific. The company is headquartered in Glenview, Illinois.
What is the cost for synovial fluid aspiration test?
The cost for a synovial fluid aspiration test can vary depending on the healthcare provider, location, and insurance coverage. It is recommended to check with your healthcare provider or insurance company for specific pricing information.
Will my insurance cover medical weight loss programs?
To find out if your insurance will cover a medical weight loss company you need to look over your insurance coverage. Every insurance provider is different and may or may not cover it.
