You are working as a health insurance professional at Walden-Martin Family Medical Clinic. Patient Phillippe Sanchez comes in for an appointment with Dr. Gerald T. Field, a psychiatrist. The this Mr. Sanchez first visit to the clinic. Mr. Sanchez has filled out the patient registration form, Mr. Sanchez Patient Registration Form.pdf Download Mr. Sanchez Patient Registration Form.pdf. On the form you notice that there are two insurance policies. The first policy is for Sunset Assurance, a family policy, under his wife's name, Maria, provided by her employer. The second policy is an individual policy under Mr. Sanchez's name. Mr. Sanchez explains that the one under his wife's name does not cover mental health treatment. He also states "Send my bill to the packaging plant. They will take care of it". You try to get further information from Mr. Sanchez but you quickly realize that he does not know much about his two policies. How can you the health insurance professional, determine the answer to these questions?

Where would you find out more information about the coverage of the American Indemnity policy and the Sunset Assurance policy?

1. Which carrier is primary?

2. Do both policies cover mental health treatment?

3. Should you send a claim to both third party payers?

4. Where would you find out more information about the coverage of the American Indemnity policy and the Sunset Assurance policy?