“In-Network” (Participating) vs “Accepting” Insurance

Choosing an Endodontist to complete your root canal is an important decision that can have significant financial implications.  It is very important to understand the difference between dental offices that are “In-Network” with your insurance and those that simply “Accept” your insurance.  This simple difference can increase your out-of-pocket expenses by hundreds of dollars.

 

What is the difference between an “In-Network” (participating) and an “Accepting” dental practice?  The following example shows how you may pay $150 with an In-Network Dentist instead of potentially $550 with a dentist that “accepts” your insurance.


That is $400 in out-of-pocket savings for the same procedure!!


IN-NETWORK (Participating):

“In-Network (Participating)” means that the dental office has a contractual relationship with your insurance company and that the dentist must charge what the insurance company tells them to charge and nothing more.

For example: Let’s say that a dentist’s fee for a root canal is $1150.00 but the insurance company says that the dentist can only charge $750. The dentist must discount his normal fee to $750.00. Depending on the policy, out of that $750, the insurance company might pay $600 (80%) and the patient might pay $150 (20%).

ACCEPTING:

“Accepting” means the dental office will accept or allow that type of insurance to be used as part of the payment. However, the dentist has no contractual obligation to follow the insurance company’s recommended fees.

Example: Let’s compare the case of a root canal. The normal price that the dentist would charge for a root canal is $1150.00. The insurance company says that it will pay $600 (80%) of the root canal procedure. The patient is responsible for the remaining $550.


Out of Pocket Expenses $150 vs. $550


There are MANY different insurance companies and MANY different plans for each insurance company!!! Contact Us at Lone Tree Office Phone Number (303) 524-9343 to discuss your specific plan with our Dental Insurance Professionals.

We are In-Network Specialists with:


Delta Dental Premier

Delta Dental PPO

Cigna PPO

Met Life

Anthem Blue Cross Blue Shield

Humana

Ameritas

GEHA

Assurant

Connection Dental


Please call if you have any questions or concerns regarding your first visit.

Please bring your insurance information with you to the consultation so that we can expedite reimbursement.