At ZL Dentistry & Orthodontics, we strive to make your dental care as seamless as possible, especially when it comes to insurance. Here’s a breakdown of how primary and secondary dental insurance works in our office, so you can understand the process and how we handle billing.

Primary Insurance

When it comes to your dental insurance, the primary insurance is the plan that will be billed first for services rendered. The determination of which plan is considered primary is not up to the patient, but rather is dictated by how the insurance policies are written. This is usually based on factors such as who is the primary policyholder or other guidelines outlined in the insurance contract.

We will base all treatment plans and subsequent copays on your primary insurance coverage. This means that the charges you are responsible for, including any copayments, will be calculated according to what your primary insurance covers and what they approve.

Secondary Insurance

If you have secondary dental insurance, we can file claims on your behalf to potentially cover remaining costs after the primary insurance has paid. However, please note that we can only submit your secondary insurance claim after we receive payment information from your primary insurance. This process can take anywhere from several weeks to several months, depending on how quickly your primary insurance processes and pays the claim.

Once we receive the necessary payment information, we will submit the claim to your secondary insurance. If the secondary insurance covers additional costs, you may be reimbursed for any out-of-pocket payments you made. If there is an excess amount paid by the secondary insurance, it will be returned to the insurance company.

What You Need to Know:

• We base all treatment plans and copays on your primary insurance. This means that you will only be asked to pay the difference based on what your primary insurance covers.

• We do not determine which insurance is primary; it is dictated by the terms of your policy.

• Secondary insurance claims can take time to process. We must wait for the primary insurance payment details before submitting your secondary claim, which can take anywhere from weeks to months.

• If there are any credits from the secondary insurance, you can be reimbursed for out-of-pocket expenses up to the amount you originally paid.

• Any excess amounts paid by the secondary insurance will be returned to the insurance company.

We’re here to assist with all of your insurance needs and ensure that the billing process is as smooth as possible. If you have any questions about your coverage, or if you need clarification on how your insurance works, please don’t hesitate to contact our office!