We Accept all PPO Dental Insurances but are Out of Network: Here’s What That Means for You

While we are considered “out-of-network” for all PPO dental insurance plans, most of our patients still use dental insurance and use those benefits for treatment in our office.

Most PPO plans allow you to see out-of-network providers and will pay money toward your care. However, your insurance may reimburse at a lower rate, which means you may be responsible for a portion of the cost such as deductibles, coinsurance, or the difference between our fee and your plan’s allowed amount (also called a balance bill).

For example: If your plan typically covers 100% of a cleaning, even out-of-network, but only allows $130 for a cleaning, and our fee is $152, your out-of-pocket responsibility would be $22.

How We Help with Insurance

We’re happy to file the insurance claims on your behalf and then bill you for the remaining balance once your insurance pays their portion. In some cases, your insurance may require sending the reimbursement check directly to you. In those cases, we simply collect full payment at the time of service, and you can expect to receive your check in about two weeks.

We aim to make this process easy and transparent for you, and we’re always here to answer questions along the way.

Why Patients Choose Out-of-Network Care

One of the greatest advantages of choosing an out-of-network dental office is freedom of choice. You get to see the dentist and hygienist that best fit your needs, not just someone listed as contracted by your insurance company.

We also believe your care shouldn’t be dictated by outdated insurance limits. If you’ve been around dentistry for a while, you know that dental insurance benefits have not kept pace with costs. In fact, most annual maximum benefit levels haven’t changed since the 1970s, while premiums have continued to rise annually.

When Insurance Still Makes Sense

If your employer subsidizes your dental insurance, you’re likely still getting good value. But if you pay for most (or all) of the premium yourself, we strongly encourage you to compare your costs with our Friends & Family Plan, an in-house membership plan that often offers better savings and simpler coverage.

Spoiler alert: Given the low annual maximums of most dental insurance plans, our Friends & Family Plan wins almost every time when you are paying the premium yourself.

Want a Better Estimate?

If you’d like a clearer idea of what your insurance will cover for a specific procedure, we’re happy to submit a pre-determination. This gives you a more accurate estimate based on your specific plan, which will be more reliable than what’s quoted over the phone or found online.

You may download a printable copy of our financial policy here:
Insurance Financial Policy