Many patients have dental insurance with in-network benefits. I realize patients want to save money and take advantage of their in-network benefits. However, there are some things patients may not know when seeking in-network providers. These things may be important for you to know.
As the list of providers may seem adequately long, take a look at your list to see about how many providers there are. Does the number of dentists compare to say over 1500 dentists? There are considerably more than 1500 dentists in the Dallas area. So, if your list of providers is less than 100 dentists, don’t you see that the list is severely limited? By selecting someone in-network, patients have very much limited their options for dentists.
So what, some may say. What is wrong with limiting options, as long as the provider is in-network, right? Well, why is the list limited? Why aren’t there a lot more dentists on the list? Well, many dentists do not want to sign a contract with these type dental plans because they limit fees which dentists may charge. While this may sound like a good thing, the fees are cut to levels at which profit margins are heavily adversely affected. This may well affect the quality of services and care. How would you handle your life if your paycheck was reduced up to 30%? Your life would be affected, wouldn’t it? Up to a 30% decrease in your paycheck would make for some very difficult cuts to your expenses, wouldn’t it? Well, imagine if you were a dentist running a practice. What would you cut in the way of expenses to enhance profitability with a reduced fee schedule offered by an insurance company?
Let’s see, what else? With many of the in-network providers, the dental offices are staffed by a group of dentists. Patients often have no idea who their dentist is going to be on a given day. In fact, turnover in many of these group practices is significantly higher than in a privately-owned, single-dentist practice. Would you want your teeth treated by the dentist “of the day?”
There are still dentists who refuse to enter into a relationship with these type dental insurance plans. Patients do have the option of selecting an out-of-network dentist. In fact, selecting an out-of-network dentist allows much more freedom of choice, since most dentists are not in-network. Moreover, selecting an out-of-network enhances your chances of maintaining a professional relationship with the same dentist over years of time. Finally, out-of-network dentists are not being “squeezed” by insurance carriers, so they have more freedom in their delivery of dental care, without the likely resultant heavier cost controls and potential compromises in care.
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