insurance networks explained
DIRECT NETWORK
When you see a dentist who is in network directly with your insurance plan, the office charges fees provided by your insurance company. These fees are typically lower than the office's standard fees. Thus, you are getting a discount.
indirect network
When you see a dentist who is in network with your plan through a third party, you will still get discounted fees. However, these fees are usually not quite as low as fees directly from your insurance company.
out of network
When you see an out of network dentist, the office's standard fees will be used. You will not get a network discount. Just because an office says they accept your insurance does not mean they are in network. You should specifically ask if their providers are in network.
OUT OF NETWORK AT OUR OFFICE
You will not get a network discount but we can file claims for and accept payment from your out of network insurance company . Our pre-treatment insurance estimates may be less accurate with these plans. Thus, you could receive a bill or a check after insurance pays your claim. Large balances can result from basic and major treatment. Thus, we recommend letting us send a predetermination to your insurance company prior to major treatments so you can get a more accurate estimate of the patient's total payment responsibility.
DELTA OUT OF NETWORK
Delta is unique because with most of their plains, Delta pays the patient rather than the dentist for out of network claims. Thus, we must collect the full fee from the patient prior to treatment. However, the following plans we are told will pay us directly and we DO NOT have to collect in full for these Delta plans: Rubicon, FMOL, Primoris, Performance Contactors, and Westlake Management.
