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Visiting an Out-of-Network Provider? Here’s What You Should Know

August 6, 2024

Filed under: Uncategorized — longmid @ 9:30 pm
dentist smiling with arms crossed

When it’s time for your six-month dental checkup, you might call your dentist only to find out they’re no longer in your insurance network. Before you go ahead with the appointment, it’s important to weigh your options. Continue reading to find out why you should think carefully before seeing a dentist who is out of network.

Higher Out-of-Pocket Costs

One of the biggest drawbacks of visiting an out-of-network dentist is the potential for higher costs. When a dentist isn’t contracted with your insurance company, they can set their own prices for services. Whether you need routine preventive care or a more extensive procedure, you’ll likely have to pay more out-of-pocket compared to an in-network dentist. Although you might be able to file a claim with your insurance for reimbursement, you’ll still need to cover the full cost upfront, which can strain your finances.

Risk of Balance Billing

Another concern with out-of-network providers is balance billing. If you’re not familiar with the term, balance billing occurs when a dentist charges more than what your insurance is willing to cover. After your insurance company pays their portion, you could be left with a significant balance that you’re responsible for paying. In contrast, in-network dentists have agreed upon rates with your insurance company, which means you won’t be surprised by unexpected charges after your treatment. Going out of network could leave you with a hefty bill that you hadn’t anticipated.

Uncertainty About Quality of Care

Choosing an out-of-network dentist also places the responsibility on you to ensure you’re receiving quality care. Insurance companies typically vet in-network providers, ensuring they meet certain standards of care. However, when you go out of network, you must do your own research to verify the dentist’s credentials and reputation. This means you’ll need to assess whether the care you receive is worth the potentially higher costs. While you might find a reputable out-of-network dentist, the process requires more effort and carries a higher level of risk.

Ultimately, the decision is yours, but carefully consider how much you’re willing to pay and how much effort you’re willing to put in to ensure your dental care is both affordable and reliable. By choosing an in-network provider, you can save money while working toward a healthier smile!

About the Practice

Long Family Dental of Midlothian is a family-owned practice led by Drs. Robert and Chris Long. We offer a comprehensive range of high-quality and affordable services, ensuring your oral health needs are met in one convenient location. We’ll do our best to maximize your dental insurance benefits and reduce your out-of-pocket expenses. If you want to know if we’re in-network with your dental insurance plan, don’t hesitate to contact us

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