In-network dentists have to agree to terms and conditions set forth by insurance companies. These restrictions can limit the type of procedures that the in-network dentist can provide for patients covered under the insurance plan. For example, the insurance company may determine that a certain type of treatment is cosmetic or unnecessary and deny payment, even if the dentist believes it is the best line of treatment for the patient.
In addition, in-network providers agree to fees for their services set forth by the insurance company. They are willing to take whatever payment the insurance company is willing to provide, which is often lower than the actual value of the procedure, clinician’s time, and materials used. As a result, in-network providers may see more patients in the same amount of time as out-of-network providers, in order to make up for the difference in payment.
On the other hand, out-of-network dentists are free to do what is best for the patient without having to worry about the restrictions set forth by insurance companies. They diagnose and treat patients with only the patient’s best interests in mind, and they are able to use the best materials and techniques to ensure the best cosmetic outcome. Out-of-network providers spend much more time with their patients and provide a more personalized experience.
While in-network providers are not necessarily subpar, they do have to answer to the insurance company and follow their rules. Out-of-network dentists have more autonomy in their practice and can provide a unique, patient-focused experience that can lead to better outcomes and greater patient satisfaction.