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The Out-of-Network Dentist Dilemma: How to Help Employees

July 30, 2015 By Shelby Tatomir

Are you responsible for managing your company’s benefits? Maybe you’re an HR professional or a multi-tasking small business owner. Either way, employees are relying on you to guide them through their employer-sponsored dental benefits.

One-in-four consumers (that’s 25 percent) who have dental insurance say they have not been to the dentist in the past 12 months due to cost. Educating employees on how preventive care saves money can help encourage them to use their benefits! Chances are, they don’t know what’s covered under their plan. For some, their favorite practitioner may be an out-of-network dentist for Delta Dental. The last thing we would want is for someone to miss their preventive care appointments because they can’t go to their favorite dentist! That’s why we make it easy to recommend their favorite out-of-network dentist to be a part of the Delta Dental of Colorado network.

A patient’s relationship with their dentist is beneficial to maintaining their oral health. While 80% of licensed, practicing dentists nationwide are part of the Delta Dental network, you may still encounter an employee who is interested in having their dentist, an out-of-network dentist, join Delta Dental of Colorado’s network. So next time an employee asks about an out-of-network dentist, use this information to lead them in the right direction.

Start with the Facts

Explain how your company plan works. Employees will almost always save money if they choose a dentist in your plan’s network. Make sure your employee understands what out-of-network means and how visiting in-network dentists saves money.

Does your plan have different coinsurance levels for PPO™, Premier®, and out-of-network dentists? If yes, you’ll want to help employees understand how their out-of-pocket savings may vary.

Why Visit an In-Network Dentist

For your employee to get the most out of their employer-sponsored dental benefits, they’ll want to visit a Delta Dental of Colorado in-network dentist. Dentists in our network agree to our predetermined fees for services, which are usually discounted from typical charges. That’s one reason why in-network dentist appointments can cost less!

When you or your employees get dental care done by an in-network dentist, you don’t have to ever worry about waiting for reimbursements, either. We pay your in-network dentist directly and send you an EOB, or explanation of benefits, to explain what you owe, if anything.

Additionally, we have high standards for your health and safety. All of our in-network dentists meet specific professionally required credentialing standards. We only work with providers who regularly ensure they are maintaining these standards.

How to Help with an Out-of-Network Dentist

If an employee’s dentist is not already part of the Delta Dental network – recommend the dentist participate in the Delta Dental network! It’s that simple. Click here to find specific information for dentists interested in joining our network.

Editor’s Note: Content updated April 2019.

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Filed Under: Dental Benefits Tagged With: b2b, best dental insurance, broker blog, broker tips, brokers, employee retention, employee satisfaction, largest network, network with the most choice, out-of-network, ppo, premier, tips for employers, tips for HR managers, workplace, workplace benefits

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