In Network or Out: Don’t Let Insurance Dictate Your Doctor

Country Lakes Family Dental

A health insurance agent and his two buddies were on an ocean fishing excursion in shark-infested waters. When the boat began to sink from a leak, they scrambled to the lifeboat, only to realize there was only a two-person capacity. While frantically trying to decide who should be in the lifeboat, the health insurance agent’s buddies noticed he had already jumped into the water and began swimming to shore. When his two friends met up with him, they asked, “How did you make it past all those sharks?” “Easy,” he replied, “professional courtesy.”

All in good humor, my insurance friends, dealings in health and dental insurance can feel like steering a ship through choppy water. Since the COVID pandemic, there is a noticeable difference in how insurance companies respond to claims. A lack of employment availability created a lack of communication with insurance companies – not to mention the ever-increasing premiums from insurance reform making it difficult to determine the worth of the service. From a provider’s perspective, despite efforts made to verify and submit insurance claims, being the middleman dampers relationships between patients and the insurance company.

The truth is, despite what many insurance companies say, your insurance cannot dictate your care or determine your health provider. This is also true in dental care, both IN or OUT of network. It is very common to file insurance in either case and receive reimbursement, regardless of the status. In many cases in the dental field, not only does the provider have more control over the treatment type and cost, but often sees better reimbursement. You should expect dental office insurance experts to do their best to help weather these situations.

Additionally, as more complications with insurance continue to arise, many dentists have created their own in-office plans that are competitive with the offerings of dental insurance. The bottom line is that your dental care is best handled through the relationship of your dental provider and not through an insurance employee. Working with both can help you maximize your benefits and acquire the dental care you deserve. Happy Smiling!

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