Navigating the ins-and-outs of dental insurance can feel like an extra burden for parents with long to-do lists already. The good news is that when you visit a knowledgeable pediatric dental office, this will be one less thing that you need to worry about. Whether they are in-network or out-of-network with your insurance plan isn’t always the most important detail—it is whether they will work with you to help maximize your savings, all while providing your favorite smile with high-quality care. Read on to learn more about the difference between in-network and out-of-network coverage.
How Does Dental Insurance Work?
Dental insurance is coverage for the care of your teeth, either provided by your employer or individually purchased. It therefore allows you to access dental care with providers who have an affiliation with your plan. As a courtesy, dental practices may file the dental claims to your insurance company on your behalf in order to seek reimbursement/coverage for the treatment rendered. What your dental insurance plan covers is up to them, and it can vary from employer to employer and patient to patient.
What’s the Difference Between In-Network & Out-of-Network?
When a practice is “in-network” with a dental insurance company, it means that they have agreed to accept negotiated, contracted rates for their services. Many parents look for “in-network” providers because they think that means the rates will be lower than a practice who is “out-of-network”; however, that is not always the case. In some cases, dental practices will adjust their rates to make the out-of-pocket costs for in-network and out-of-network patients similar.
How Should You Decide Whether to Visit an In-Network or Out-of-Network Office?
When deciding whether to go to a pediatric dentist that is in-network or out-of-network, you should also consider the quality of care that your child will be receiving. Is the expert a pediatric dental specialist? Are they board-certified? Do they offer a comprehensive list of services to help your child throughout every stage of their oral development? Sometimes, the difference in cost between an in-network and out-of-network dentist is so little that it makes the most sense to shift the conversation to quality of care.
If you have any questions about how your pediatric dental office files dental claims, what insurance plans they accept, and which ones they are contracted with, the best thing to do is give them a call. If you find your child a dentist that you both trust, you may even consider signing up for their in-house membership plan. Office-based membership plans often provide crystal clear coverage with additional discounts on other needed services for one flat annual fee!
About the Practice
At Tooth Clues – The Dental Detective for Kids, we accept most PPO dental insurance plans and are happy to file claims for our patients to maximize their savings, regardless of whether we are in- or out-of-network. Our top priority is to make you and your child’s experience with us enjoyable and stress-free! Additionally, our knowledgeable staff is always happy to answer your questions about your plan at any time—just give us a call!