If you’re trying to make the most of your dental insurance coverage, you may be wondering just what it means for a dentist to be “in-network.” As is the case for most dental insurance questions, the answer is complicated. Read this post to find out more about in-network and out of network dental insurance coverage and how you can find the right dental office and dentistry services to ensure you receive the insurance benefits you deserve.
What Makes a Practice “In-Network?”
In-network dental offices have established a contract with your insurance provider. The contract is an agreement that the dentist will charge a set fair and average price for covered treatments. As long as treatment costs fall within the agreed upon range, you will only need to pay the out of pocket percentage of your care and the insurer will pay the rest. These contracts are beneficial for patients because they ensure your dentist can offer optimum insurance coverage for all of your necessary treatments.
Can I Visit an Out of Network Practice?
Most dental insurance plans are set up to allow patients the flexibility to choose the best dentist for their family even if they’re out of network. You may need to pay slightly more for treatment at an out of network practice, but the difference in cost is typically minimal. If you have an HMO or Medicaid insurance plan, you may not be able to receive insurance coverage when you visit an out of network dental office. Be sure to talk to your dentist or dental office team about coverage prior to your treatment to ensure you receive the benefits you deserve.
Is it More Expensive to go Out of Network?
You may need to pay a slightly higher fee if you visit an out of network dental office. Because these offices do not have contracts with your insurer, they can charge any fee for their dental services. If these fees are higher than the insurance plan’s fair and average price, you will need to pay the difference in cost as well as the out of pocket percentage of your treatment price. For most treatments, this difference in pricing will be negligible.
Meet the Smile Fitness Dental Centers Team
At Smile Fitness Dental Centers, our Phoenix dentists and dental team are happy to process and file dental insurance claims for most benefit plans. For our patient’s benefit, we are in-network with many insurance providers, including Delta, BlueCross BlueShield, Cigna, Guardian, United Health Care, and Humana. If you want to find out more about our services or dental insurance coverage, please don’t hesitate to contact the Smile Fitness Dental Centers team. We look forward to helping you get the dentistry services you need within your budget.