In-network or out-of-network: Pros and cons for your dental practice

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At a certain juncture, every dentist ponders: whether you’re commencing a fresh dental establishment or seeking to implement alterations at your existing one.

Should my dental clinic participate in-network or out-of-network with dental insurance?

Both options can affect your billing and claims process. You should consider what is best for handling the process that you have in mind or want. If you want to handle the process yourself, you need to consider what is best for going to work with billing and claims. Alternatively, if you plan to hire a service or people to handle the process, you need to consider what is best for going to work with billing and claims.

Each alternative has its advantages and disadvantages. The benefits and drawbacks of both kinds of dental practitioners can be observed by analyzing their insurance claims over a decade of assisting both dentists who are part of a network and those who are not. Dental ClaimSupport provides assistance to both in-network and out-of-network dentists in handling their claims procedures.

You will gain a comprehensive understanding of the advantages and disadvantages of your practice being in-network or out-of-network with insurance by reading this article. We will discuss the meaning of each option and examine the pros and cons associated with them.

You will then have the ability to make an informed choice on which option best fits the requirements of your practice.

Curious how outsourced dental billing can benefit you, no matter what kind of practice you are in?

Your objectives are determined by what aligns more suitably with your practice, determine which option is a superior match for your practice. The manner in which you handle patient experience and payment collection has a significant connection to numerous patients. There are numerous advantages and disadvantages associated with being in-network and out-of-network with dental insurance.

When it comes to insurance claims, ClaimSupport Dental is a valuable resource for practices hoping to collect 100% of their insurance claims. You can always choose someone responsible for billing insurance for your dental insurance, and it doesn’t matter whom you choose.

Learn more about how outsourcing dental billing can benefit your practice, regardless of whether you have a contract or specialize in a particular area of insurance.

What does it mean to be an out-of-network dental practice?

Patients can determine the type of care they receive without the involvement of the insurance company. While you have the option to charge your complete fee to patients, you still acknowledge insurance. As you may have inferred, an out-of-network dentist does not have any contractual arrangement with insurance companies.

There are certainly some significant advantages to being a dentist who is not part of a network.

Pros of your dental practice being out-of-network

One of the biggest pros of being in-network is that you still have the opportunity to deal with dentists who accept insurance at the same rate. The insurance company has no say over what you say or what you do, regarding the patients you accept. It allows you to retain control over every part of your practice.

Here are the advantages of being an out-of-network dentist:

If you find the services offered in your area not widely available, especially the ones that cater to your specific needs, it can be quite appealing. It is worth considering the significant benefit of being able to decide what services are worth it to you, even if they are out-of-network. You worked hard to attend dental school, and it is understandable that you didn’t want insurance companies dictating your fees. Being able to control your own rates for dental services can truly feel liberating.

Many dentists are increasingly opting to transform their dental practices into fee-for-service establishments. This payment method can be adopted if you are not affiliated with any particular network. In such cases, dentists can collect the entire fee from their patients and then file a claim on their behalf, allowing them to be reimbursed by their insurance. Thus, it is possible for dentists to transition into a fee-for-service model.

Having control over your practice is extremely valuable. However, let’s delve into the disadvantages of your dental practice not being in-network.

Cons of your dental practice being out-of-network

Certain individuals discover it excessively costly, and it renders your practice more challenging for patients to locate. Particularly if they are unfamiliar with where to commence regarding their pricing, opting for out-of-network services can appear somewhat daunting for certain dental staff.

These are the disadvantages of your dental practice not being part of a network:.

If your goal is to make dental care affordable and accessible for patients, you might not want to be out of the network. Of course, you could decide to lower your fees. However, realistically speaking, it is not really possible to run a dental practice without quality equipment. But if you are trying to grow your patient base, you will have to spend more time on marketing your practice.

Additional effort will be needed from your team, necessitating a more efficient patient billing system. It will be necessary to collect the appropriate amount from patients, which can become more complex due to the elevated fees. This is a practice followed by accomplished dental teams that operate outside of network. Do they allocate time to clarify the reasoning behind your fee structure? Does your team have the capacity to engage with patients and elucidate their benefits? Given the higher fees, it will be essential to invest more time in patient billing.

If your goal is to increase patient accessibility and affordability, being out-of-network is not likely to be the right choice for you.

What does it mean to be an in-network dental practice?

When your dental practice becomes a participating provider, it means that you are entering a contractual agreement with insurance companies to define the rate of your fees and the process of reimbursement claims for the patients who come into your practice. This makes your practice in-network with insurance companies, allowing you to enter into a contractual agreement with them.

Patients who are covered by the insurance your practice is in-network with receive discounts on services when they visit those dentists. Let’s examine the advantages of your practice being affiliated with insurance companies.

Pros of your dental practice being in-network

Many dental practices allow patients to enjoy the ease and affordability of going to in-network dentists because their insurance accepts that finding a dentist. This gives patients access to the insurance because they choose to be in-network with dental practices.

Here are the advantages to your practice if you decide to join the network:

This is a great opportunity for a small practice to grow its patient base. Patients will be able to easily find your practice in their insurance portal. Being in-network with the insurance company means that your practice will be promoted for free. You can benefit from free advertising and marketing.

If your goal is to increase the quantity of patients, being in-network is probably your best choice. Being in-network can bring more money for your practice and it means you will stay full on schedule. You will have plenty of patients and you will be easily accessible because you are being promoted by your insurance. This will attract more patients.

Now, let’s delve into the disadvantages of your dental practice being affiliated with insurance networks.

Cons of your dental practice being in-network

Let’s say you have signed a real contractual agreement with dental insurance companies, and when it comes to getting the money you’ve earned, there are some drawbacks that you need to accept.

Here are the disadvantages of your practice being in-network.

When you go to a dental practice that is in-network with your company insurance, you agree to fees established for your services. We use the term “agree” loosely. It can be challenging to negotiate these fees. Typically, insurance will just tell you what the fee is. This can be a drawback for dentists who want to charge more for their services.

This team member at the front desk, such as a dentist or a front desk staff, might feel pressed for time when they have back-to-back patients. Sometimes, focusing on quantity can compromise the quality of patient care. Well, let’s not forget how an increase in patient base can sometimes take away from the time spent on each patient.

Being in-network is a common option among dentists because it ensures accessibility and affordability for patients. However, not every dental practice prioritizes these factors. Let’s explore the concept of being out-of-network as a dental practice.