Out of Network Insurance

Why should I consider an out-of-network provider?

While insurance premiums increase annually, often the patient's benefits and coverage stay the same. Similarly, fee schedules a dentist is given by an insurance company for their services may stay the same, rise minimally each year (not in keeping with inflation/staffing costs), or even decrease. This means dentists who are in-network with many insurances may have to schedule “efficiently” with shorter appointments for procedures, choose less desirable materials/labs, work with more inexperienced team members and are unable to keep up with available technology.

Another consideration for patients is that insurance companies try to dictate treatment by denying payment or downgrading treatment unless it falls under their specific parameters, despite the patient having benefits to use. Many times these insurance driven parameters are a reactive type of treatment once a tooth has gross decay or has fully fractured. There are many situations where a doctor recommends restorations that will be more preventative and protective for a tooth with the intent of requiring less treatment overall, but insurance companies will deny that recommendation. Patients can still choose to have the procedure completed, but their insurance will not contribute to payment in those instances, despite the patient having benefits.

Unfortunately insurance companies use scare tactics to train consumers that out-of-network providers are “bad” and more expensive. Their websites use language like, “beware of out-of-network providers,” and “avoid paying high out-of-pocket costs.” They don’t explain that even with in-network insurance, you will still have out-of-pocket costs, or that your treatment could be downgraded or even denied by your insurance company!

Elite Dental has always been committed to delivering quality dental work and spending the necessary time with our patients to achieve the best results possible. We refuse to compromise how we deliver dental care, and so have chosen to change how we partner with insurance companies so our patients can receive the care they have come to expect.