Does your dental practice accept most major insurance plans? Ensuring patients understand the difference between in-network and out-of-network dental benefits is a key aspect of patient billing. Does your office have a process for explaining out-of-network dental benefits to patients and alternative payment methods like dental financing?

In-Network vs. Out-of-Network Insurance Coverage

Your practice’s patient education should begin by explaining which insurance coverage you accept as an in-network provider. If your patient has an insurance plan you accept, explain any limitations in coverage. Most insurance providers don’t cover cosmetic dentistry, for example. Review your patient’s policy thoroughly to ensure you know how to submit requests to their insurance provider.

If your patient has dental benefits from an out-of-network insurance company, explain what that means for your patient’s liability compared to their insurance provider’s. An insurer often offers both in-network and out-of-network benefits but will cover less of the total bill for an out-of-network procedure.

Each patient may have a different deductible to meet before their insurance coverage kicks in. Some insurance companies may not offer out-of-network coverage until the policyholder meets their deductible. Review patient insurance coverage with them so they understand their billing obligations before their first procedure.

Developing Patient Education for Their Dental Benefits

Patient education ensures patients get the most from their dental treatment plans. Many patients will choose a dentist based on finding an in-network provider. However, if a patient already has a wonderful dentist at your practice and is considering changing providers because of the type of insurance accepted at another office, you can educate the patient on the out-of-network benefits still available to them.

Do you have appropriate materials for explaining out-of-network dental benefits to patients? What are your options for communicating the potential dental benefits available to patients with other insurance coverage?

Options to consider for patient education include:

• Pamphlets, brochures, or booklets offering key insurance terms and information about common coverage limits
• Blog posts on your website about insurance coverage for dental patients and what most policies cover
• Social media posts and ads about out-of-network benefits and low-rate dental financing options

Explaining Out-of-Network Dental Benefits Offered at Your Dental Practice

Why the big push to ensure patients know their options? If a patient considering your dental practice realizes your office isn’t in their network for insurance coverage, they may look elsewhere for a new dentist. By educating prospective and existing patients that they may have out-of-network dental benefits through their insurance company, you can continue to attract new patients and retain existing ones.

The challenge is reaching prospective patients before they choose another office. Making your educational materials readily available in print and online is essential for your dental office marketing strategy.

Pros and Cons of Being In-Network vs. Out-of-Network

You may think you can only get new patients as an in-network provider or through dental financing for patients who don’t carry dental insurance coverage. However, there are several advantages and disadvantages to consider when choosing which insurance plans you’ll accept as an in-network provider. The major pros and cons of being in-network are as follows:

Pros of Being In-Network

• Insurance portal listings for your office or offices as an in-network provider
• More patients who carry accepted insurance plans for dental care
• More patients who stick with their dental treatment plans for regular cleanings and dental procedures

Cons of Being In-Network

• Additional patients can overwhelm smaller dental practices
• Non-negotiable procedure fees
• Less time to spend with each patient during appointments due to higher booking volume

Because dental procedures are more affordable with an in-network dentist, many patients prefer going to a dental practice covered by their insurance. However, there are pros and cons to consider as an out-of-network provider as well, including the following:

Pros of Being Out-of-Network

• Choosing your own rates for dental procedures
• Greater control of your office billing processes for out-of-pocket and insurance claim payments
• Fee-for-service billing options to get paid immediately and seek reimbursement from the patient’s insurance company on behalf of your patient

Cons of Being Out-of-Network

• Higher costs for billing department labor
• Less accessible for some low-income patients

Getting paid by insurance or out of the patient’s pocket is easy with Dental Intelligence Payments and Insurance. Learn more below.

Process Patient Payments Quickly and Easily With Dental Intelligence

Now that you know how to explain out-of-network dental benefits to patients, help them develop a patient payment plan. Dental Intelligence offers several payment options. Schedule a demo today.