What date will you be out of network with Delta Dental?
Our target date is April 1, 2023
Will you still file a Delta claim for me?
Yes! And we will continue to fight on your behalf with any claim denials or appeals.
Does Delta still pay the office?
We have been told that once out of network, Delta will send the payment for services to the patient, not our office. Therefore, we will request payment on the day of service and Delta will reimburse you.
Can I come to your office if I am out of network?
Yes! We take most insurances. As long as you have out of network coverage with your plan, you can continue to come to our office.
Will I have a copay or higher out of pocket expenses?
Potentially. You will be responsible for any differences between what our fee is and what your insurance pays.
Our fee is $100 for a procedure. $100
Your insurance pays $80 for the procedure. -$80
You would owe the $20 difference. $20
The biggest unknown at this point it what fee schedule your insurance will use to pay claims. We cannot predict what the fee schedule will be once we are out of network. Again, if there is a difference between what our fee is and the insurance fee schedule, you will be responsible for the difference. Again, we won’t know what, if any, difference there will be until we submit a claim for you and receive payment from your insurance.
Ways to offset copays:
HSA (health savings account)-allows you to set aside dollars for potential copays
FSA (flex spending account)-employer based account allows you to set aside money for copays
Savings account-putting aside a given dollar amount each month so you have money for copays