What in-network and out-of-network mean
When a practice is in-network with a plan, it has agreed to that insurer’s set fees. When it’s out-of-network, it hasn’t signed that agreement, so it sets its own fees. Your plan can still contribute either way. The difference is usually how much, and how the paperwork flows.
Being out-of-network does not mean your benefits disappear. It means we help you use them a little differently, and we make that part easy.
The bar we hold
We go in-network with a plan when its reimbursement lets us keep the things that make our care what it is: quality materials, an experienced team, and real time with you. Many plans clear that bar, and we are in-network with them.
A few do not. With Delta Dental, for instance, the rates today are too low for us to deliver that level of care, so we stay out-of-network rather than cut corners. You are still welcome, and we help you make the most of your benefits.
Caring for as many patients as we can
Our goal is simple: to care for as many patients as we can, and to do it in a way that never lowers the quality of that care. That is the lens we bring to every plan. We move one in-network whenever its reimbursement lets us hold our standard, so the list keeps growing.
If we are not in-network with your plan yet, that can change over time. In the meantime, plenty of our patients see us on an out-of-network basis and still make good use of their benefits. Send us your plan and we will tell you exactly where you stand.
What being out-of-network means for you
In practice, it is usually far less of a hurdle than insurance language makes it sound. Depending on your plan type, many patients stay fully covered for their routine exams and cleanings, and see little difference in the overall cost of treatment. In our experience, around 90% of our out-of-network patients remain fully covered for those routine visits.
Where there is a difference, we want you to see it before you decide, never after. Our team does everything we can to give you a clear sense of your out-of-pocket cost ahead of time, so the choice is always yours to make with the full picture in front of you.
How we keep billing free of surprises
Before your visit, we verify your coverage and walk you through any co-pays, so you know what to expect going in. We file and submit your claims for you, and we stay on them until they’re settled, working to get you as much from your plan as possible.
After your exam, you receive a written treatment estimate within three business days. It’s a careful estimate, and we work hard to make it accurate, so nothing about the cost is a surprise before you decide. If it helps to spread payments, we offer financing through Cherry. We accept PPO plans only, not HMO, DHMO, Medicaid, or Medi-Cal.
Not the cheapest, not the most expensive
Our fees sit in the middle, on purpose. They’re set so we never have to compromise on the materials we use or the team who cares for you. What you get in return is careful, evidence-based dentistry, explained in plain language, with the decision always staying yours.