23 March 2016
There seems to be a love/hate relationship with good ol’ insurance. Most of us have it but sometimes we wonder what the heck is it really doing for us. Well I am here to give you a little advice on the in’s and outs of the world of dental insurance.
First, one of the biggest questions we receive about insurance is……” Are you in network or out of network with my insurance?”
This is a great question, so let’s break it down!
Sometimes dental insurance has a set of benefits for you if you see an in network dentist and a set of benefits if you see an out of network dentist. The funny thing is that often, well let’s be real, most of the time, these benefits are the same. The only difference is that if you see an in network dentist, your dentist may be writing off a portion of your procedure if the fee exceeds the allowable charge.
Let’s talk about allowable charges. You see, insurance does this interesting thing where they take a specific demographic area and calculate an average fee for a certain service and call that the allowable fee. So for dentists participating in the network with that insurance and charging more than that allowable fee, they will be writing off the difference. If your out of network dentist is charging an average fee for your area, then your out of pocket is no different than seeing that in network dentist. Make sense? So in a nutshell, if your dentist is charging average fees for your area, then you are probably not going to receive any additional benefit by seeing an in network dentist.
Our office understands the importance of you wanting to utilize and benefit from your dental insurance, but we also want you to fully understand what that means and help you to receive the most superior treatment, while also utilizing your insurance. Our office does participate with a few insurance companies; Delta Dental, Aetna and Blue Cross and Blue Shield, but we actually work with several hundred insurance companies as out of network providers and our patients are not noticing any coverage mishaps by seeing us, an “out of network” dentist.
It is no secret that insurance can be a confusing and frustrating beast at times, but please know we are here to help you understand and utilize those benefits to the fullest, so if you ever need to go through those benefits, we are here to help!!!