Dental Insurance: Out-of-Network vs In-Network

We recently made the decision to discontinue our contracts with all insurance companies and be a fee-for-service dentist office. We hope this article will help you understand our decision and what this means for you. We encourage you to call our office at (757) 229-1224 if you have any questions!

Why did we go out of network?

Dental insurance companies have had changes in their policies. Those changes forced all member-dentists to make a choice between quality care and in-network benefits. We chose to keep using the best materials and local laboratories. We refused to lower our quality of care and were forced to start taking dental insurances as an out-of-network provider.

What insurances do we take?

We are a fee-for-service dentist office. This means we are not contracted with any insurance. We have a direct relationship with patients and we treat patients based on what is best for their dental health, not what the insurance company wants to pay for. We do still file claims with insurance companies as an out-of-network provider so we can still maximize your dental benefits.

What is the difference between in-network and out-of-network?

If a healthcare provider is in-network, it means they are contracted with the insurance company and have agreed to discount their fees for services provided and allow the insurance to downgrade treatment to the lowest cost for them, not the patient. If a provider is not contracted with the insurance company, they are considered out-of-network and will be able to provide the best possible treatment to patients without the frustration of little to no reimbursement. .

Do you need to find a new dentist that is in-network?

No! Most insurances have out-of-network benefits so we can still claim your dental benefits. We will still handle the claim submission and all of the paperwork. You will just be responsible for the remaining balance that your insurance company did not pay.

How much will my cleaning be?

Come into the office for your next cleaning. We will honor your usual insurance benefits and be able to give you a quote for what future payments will look like. Lots of patients pay as little as $10 for their cleanings.

How to see your dental insurance benefits:

Most insurance companies have a way you can access your dental benefits online. You can contact the customer service number on your insurance card and they can walk you through how to set that up online.

Is it worth it to have dental insurance?

IHC Specialty Benefits, Inc reported the average cost for a dental plan per person in Virginia ranges from $26 to$82 a month so it costs roughly $312 to $984 a year to have dental insurance. If you are using insurance for routine exams and cleanings, it may be cheaper to pay out of pocket.  Our average cost for 2 regular dental cleanings a year is $550. So, there are a lot of patients that spend more money having dental insurance. Look into your specific dental plans cost and what it covers to find if it is worth it for you.  Many people have insurance premiums deducted from their paychecks, so out of sight out of mind!  It would be a great idea to really look at what you are paying against the benefits you get.

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