If your dental provider is considered “out of network,” it means they don’t have a direct billing agreement with your insurance company. But that doesn’t mean you can’t still use them — it just means you may need to pay upfront and submit the claim yourself.
Here’s what to expect:
🏥 In-Network vs. Out-of-Network
In-network dentists have a contract with your insurance provider and offer direct billing.
Out-of-network dentists may still accept your plan, but don’t bill the insurer directly — you’ll pay at the visit and request reimbursement later.
💰 Will You Pay More?
Sometimes, yes. Out-of-network providers may:
- Charge higher fees than your insurer’s approved rates
- Not be covered at the same percentage (e.g., 50% instead of 80%)
- Require you to handle the paperwork
✅ What You Can Do
- Call your insurer to confirm out-of-network coverage
- Ask your dentist for a pre-treatment estimate
- Submit your receipts with the correct claim forms
Still Want to Stay With Your Dentist?
Many patients prefer the quality of care and convenience of a trusted clinic — even if they’re out of network. We’ll help you get the documentation you need to make claiming easy.
👉 Call us to learn more about how we work with your plan — in or out of network.