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Does it Pay to Go with an In-Network Dentist?

December 19, 2017

dental Insurance coverage formsMany patients we talk to tell us they picked a dental office entirely based on whether or not the dentist was in-network with their benefit plan. While this a valid reason for choosing a practice, it’s important to realize it’s just one of many factors you should consider before selecting a dental office. In fact, most dental insurance plans are structured to accommodate the patient’s right to choose the best office for their unique oral health care needs not just specific dentists who are in the plan’s network. In this post, we’ll look at the benefits of choosing the right practice whether or not it’s in your dental insurance network.

What Does “In-Network” Really Mean?

In-network dental offices have agreed to the fees for service that your dental benefit plan determines to be fair and average. This guarantees that you will only ever owe the out of pocket percentage of the price of your treatment. In some cases, in-network providers are more likely to allow the dental insurance plan to dictate what the best treatment is for their patients. It’s important that both in and out of network dentists take the time to explain all of your treatment options and the associated costs, so you can make an informed decision about the dental services you need.

How Does Visiting an Out of Network Dentist Effect Coverage?

Patients with a PPO dental insurance plan will not likely notice the difference between in-network and out of network coverage, which in most cases is nothing more than a slightly higher fee. For instance, a service your benefit plan says should cost $100 and receive 50% dental coverage would cost you $50 from an in-network provider. For some services, an out of network provider may charge more than your benefit plan’s fair price. In the case of the $100 service above, an out of network dentist might charge $110. You would be responsible for your half of the fair treatment cost of $100 as well as the additional $10 charged by your provided, making your total out of pocket cost $60. For the most part, the changes in your out of pocket costs are negligible.

Meet the Oyler Family Dentistry Team

At Oyler Family Dentistry, we’re not in-network with any specific dental insurance providers, but our team works with a wide range of benefit plans on a daily basis. We will be happy to process and file claims for patients, submit pre-determination forms, and help you maximize your dental insurance coverage. Call our Lawrenceburg dentist and team to find out more about dental insurance coverage or schedule your first appointment today. We look forward to seeing you soon.

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