Why We Opt Out of Insurance Networks

There are several reasons why we are not in-network with many plans:

• You should have your choice of dentists and not have this choice limited by the employer or insurance carrier based upon lowest price.
• You should select your treatment, together with your dentist. Insurance carriers exist to make money. They often dictate treatment options that are not in the best interest of the patient or are not what the patient wants.
• The rates of reimbursement by many insurance carriers are less than the cost of providing the treatment, forcing dentists who are in these plans to find ways to cut corners and cut costs that are not in the best interest of the patient. Cut rates also force dentists to focus on speed and quantity of procedures rather than focusing on the patient, and the quality of care.
• The dental team (staff) play a significant role in the level of care and service the patient receives. High quality, well trained, experienced, motivated, and caring staff deserve good pay and benefits. Practices trying to operate at lower rates of reimbursement pay staff less and have higher staff turn-over. The quality of the patient experience is reflective of the quality of the staff delivering that care.
• Insurance premiums increase annually, yet annual limits of coverage do not change. In fact, in many cases the annual coverage limit is the same as it was 50 years ago. Insurance companies collect more and more money, while the patient’s benefits declines in value each year.
• We believe in a fair open market. Insurance networks negotiate special deals with large corporate franchise types of dental practices paying them more than independent owner/operator dentists. This is illegal, and there are currently several lawsuits in progress against this practice.
• Insurance companies often misinform patients and the dental office is made to look like the bad guy, creating upset between the patient and the office. For example, the dental insurance may say they will cover a procedure, and then later deny the patient coverage. They may cover a procedure for one patient at a given rate, but another patient in the same plan for the same procedure, at a different rate, making it virtually impossible for the dental office to tell the patient what to expect in terms of cost, so the dental office always looks wrong, in spite of their sincere efforts to give good information.
• When dental insurance first came in existence decades ago, it was a good program and many dentists joined in supporting the idea. In recent years the dental insurance industry has become progressively worse in many ways, and many dental offices, including ours, are progressively dropping their participation as the programs harm patients. Those dental offices continuing to participate sometimes tend to be practices patients would not choose for themselves, given a choice.