The Differences Between Contracted and Non-Contracted Benefits

Finding a suitable insurance plan that meets your budget while offering you the benefits you require can be a daunting task. Making sure your dentist is contracted under that plan is of equal importance. As this is a major consideration for many patients, we’d like to help you understand the role your insurance benefits play in each scenario.

Seeing an In-Network Dental Provider

When you visit a dentist within your insurance’s network, their office will bill your insurance directly for any services rendered. After receiving the claim, your insurance will cover the cost of treatment based on your plan’s allowable and the contracted rate they have with the dentist. In many cases, this is more cost-effective than a visit to a non-contracted dentist’s office and definitely more affordable than paying out-of-pocket. For most preventive and diagnostic services, your responsibility is minimal if anything.

It’s also important to note that credentialing to become an in-network provider is no easy feat. Each insurance company has their own set of requirements for a dentist to become an in-network provider. Dental professionals who go through this process show determination and attention-to-detail, qualities which they also apply to your care.

Using your Non-Contracted Benefits

While patients with PPO plans have the option of receiving care at any practice that accepts their insurance, it may not always be worthwhile to assume the additional out-of-pocket expense. Similar to the process for in-network providers, a practice who is out-of-network will still send a claim to your insurance directly. However, since there is no agreement made between your dentist and your insurance plan, you will be responsible for a larger portion of your treatment costs. The distinction between in-network and non-contracted benefits becomes more apparent when extensive procedures are required to address your oral health needs.

Contact Us Today!

At Center for Adult Dental Care, we accept several different dental insurances and have the distinction of being in-network with most major PPO plans. If you’re seeking comprehensive care in the Burlington area and would like to know if we’re a provider for your insurance, give us a call today. We’d love to hear from you!