What Does it Mean to be an Out-of-Network Dentist?

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We hear it every day: “Do you take my insurance?” Well, of course we do; we take every insurance, we are just not “in-network.”

“What does it mean to be ‘out-of-network?’” Excellent question. Complicated answer…

Your insurance company allows you to see ANY dentist of your choosing; however, the cost may be different for an “out-of-network” dentist as opposed to an “in-network” dentist, and sometimes there is NO difference. To really understand, I’ll have to explain a little bit about how dental insurances work.

In order for a dentist to become “in-network,” the dentist signs a contract with the insurance company in hopes of attracting new patients. The dentist is on the insurance company’s website, and is searchable. An “in-network” dentist has this advertising advantage, but with this comes a caveat. The insurance company, in promising the dentist new patients, tells them how much to charge each patient and what they will pay the office. Not every time, but many times, the dentist is forced to double- and triple-book patients to make ends meet, because just getting “in-network” can come with a price. Sometimes you are given a rushed appointment, or the office has to use lower-cost materials.

Numerous insurances have great coverage if you go to an “out-of-network” dentist. These “out-of-network” dentists frequently can use better materials and will spend more time with their patients, simply because they can.

Numerous insurances have great coverage if you go to an “out-of-network” dentist. These “out-of-network” dentists frequently can use better materials and will spend more time with their patients, simply because they can. We are not limited by contracts with dental insurance companies on how to do things.

Many “out-of-network” dentists will file your insurance as a courtesy to you as their patient, and your insurance company will pay them for the same work you have done by them vs. their “in-network” dentists. Your insurance company doesn’t want you to know this, because they naturally want all dentists to become “in-network” with them and be contracted with them.

Coverage wise, you may see no difference going to an “out-of-network” provider, or you could see a small difference; you very well may see better coverage with the “out-of-network” provider, and practice philosophy-wise there can be a huge distinction in favor of the “out-of-network” provider.

The only way to find out what to expect is to call Katy Trail Dental and let us investigate on your behalf, as each insurance is different. We can help you get the most out of your insurance; after all, you pay for that coverage, don’t you?!