Navigating the ins-and-outs of dental insurance can be stressful and complicated. As a result of not fully understanding the details of your insurance plan, it can be difficult to choose a dental office that will help you maximize your benefits. If you’re on the hunt for a new dentist who can make the most out of your insurance, all while providing you with the high quality of care you deserve, is it best to choose someone who’s in-network or out-of-network? Read on to learn the difference between in- and out-of-network providers.
What’s the Difference Between an In-Network and Out-of-Network Dentist?
If you have a PPO dental insurance plan, you have the choice between seeing any dentist you want, whether they’re in- or out-of-network. This can make your pool of possible future dentists much bigger. Before you narrow your results down, you’ll want to understand the difference between seeing someone who’s in-network and out-of-network with your dental insurance plan.
An in-network dentist means that they have negotiated discounted rates and fees with the insurance company, meaning they will charge you less due to their contract with your insurance plan. On the flip side, an out-of-network provider means that, while they will file an insurance claim on your behalf, they don’t offer patients with specific plans discounted prices. This typically results in a higher out-of-pocket cost.
Does “Fee-for-Service” Mean Out-of-Network?
There is a spectrum of fee-for-service dentists, with some being more insurance-friendly than others. Most dental offices, regardless of their relationship with dental insurance, will file claims on your behalf. However, a fee-for-service provider will likely require you to pay for the services you receive at your appointment. They will then file the insurance claim so you can receive reimbursement from your insurance company.
Out-of-network dentists will have you pay the estimated out-of-pocket cost after conducting a benefits check on the service you’re receiving. That way, you won’t have to worry about waiting for a reimbursement from your insurance company.
Can Choosing an In-Network Dentist Help You Save Money?
In short, choosing an in-network dentist will help you save money because they are contracted by your insurance company to charge you less for their services. In many cases, this results in much lower out-of-pocket expenses on covered services for patients, like preventive care, crowns and bridges, and sometimes even orthodontics.
Although more and more dental offices are beginning to fall out-of-network with insurance plans, there are still countless providers out there that are in-network. The best way to find them is by either contacting your dental insurance company directly or logging onto their website to browse a list of their in-network dentists in your area. You can also call the dental office you’re interested in visiting directly and ask them!
About the Practice
At Midtown Family Dentistry of Dallas, our team is led by three highly experienced and compassionate dentists, Drs. Koo, Arnold, and Patel. Their aim is to offer affordable, high-quality dental care to families in and around Dallas, which is why they are in-network with most major dental insurance companies, like MetLife, Cigna, Humana, Guardian, BlueCross BlueShield, and many more. To schedule an appointment, visit our website or call 469-529-6016.