I have an example where a dentist in California has a contracted rate with Delta, which paid 90% to the contracted rate. The secondary insurance, Guardian, did not have a contracted rate with the dentist. Still the secondary insurer only paid the remaining 10% of the primary's contracted rate, and called the patient's responsibility $0.00.
The dentist disagrees, and claims the balance to the non-contracted rate is owed by the patient or secondary insurer.
Answered: Jul 02, 2010