You’re long overdue for a six-month dental checkup, so you call your dentist to try and find a time to get in. It isn’t until you are talking with the front desk that you learn they are out of network with your dental insurance. Should you go ahead without much concern or rethink your decision? Here are 3 reasons you should stop and think before visiting a dentist who is out of network.
You Can Expect to Pay More for the Services You Receive
When needing a minor or major restorative procedure or even general preventive care, there is a chance that you’ll be required to pay for at least part of these services out of pocket. If a dentist is not in an agreement with a particular dental insurance company, they can choose to charge whatever they want.
While there is the option of filing a claim so that you can be reimbursed, you’ll be required to pay at the time of treatment, so you’ll have to pay more upfront than if you were to see a dentist who is in-network with your particular plan.
You Could Be Forced Into Balance Billing
If you’re unsure what balance billing is, do not be alarmed, but consider how it may affect your oral healthcare costs if you choose an out-of-network dentist.
Because dentists who are out of network can determine the price for the services they offer, they can charge any amount they choose and bill you the remainder after your insurance company has paid their part. This is what is known as balance billing.
When choosing someone who is not contracted with your dental insurance company, you run the risk of having to pay any additional costs that your insurer will not cover. This is different than an in-network practice that agrees upon the cost of treatment beforehand so that you’re not left with high out-of-pocket costs when it’s all said and done.
You’ll Be Required to Determine the Quality of Care
When it comes to your oral health, you don’t want to risk choosing the wrong dental professional (or the cheapest). Since most dental insurance companies hold practices to a set of standards, they can choose to keep or drop a particular relationship if they feel the dentist is not providing the highest level of quality care.
However, choosing someone who is out-of-network means the responsibility rests on you. You’ll have to find someone you can trust with the appropriate credentials, determine the best rate for the service you plan to receive, and take your own notes.
While nothing dictates that you must see an in-network dentist, it’s no secret that they will enable you to save more in the short- and long-term on your oral healthcare. Consider your options and decide how you would like to keep more money in your pocket while working toward a healthier smile.
About the Author
Dr. Anil Patel is a trusted dentist in Fort Worth who completed his Bachelor of Dental Surgery at the Government Dental College of Ahmedabad in Gujarat. Moving to Fort Worth to pursue a master’s degree in public health, he earned his Doctor of Dental Surgery at the University of Southern California School of Dentistry in Los Angeles. Helping patients get the care they need at a price they can afford, he is pleased to welcome most major dental insurance plans so that individuals can save more. To find out how he can help maximize your benefits, visit our website or call (817) 717-6788.