Duffel Dental is contracted with most major insurance companies, but we also work with any plan for which a patient has Out-of-Network benefits and can choose which provider they want to see. Our front office team will do a complimentary benefits check if you have any concerns regarding your current insurance to determine basic eligibility and coverage at our office.
In Network Versus Out of Network Coverage:
If you come to see us and you are “In-Network,” if there is a difference in the fee for any particular service, between what OUR fee is and what your insurance “ALLOWS” for that service, i.e. “Allowable Fee,” then we write-off the difference. For preventive and diagnostic services covered at 100%, with no deductible due, this will usually mean that you will not have an out-of-pocket cost.
If you come to see us and you are “Out-of-Network,” it simply means that if there is a difference between OUR fee and the Allowable Fee set by your insurance, you are responsible for the difference. Our fees are based on “usual and customary Rates” for our area (based on zip code) and are usually still within or very close to the Allowable Fees set by a lot of insurance companies who base benefits on the Usual and Customary Rates. For most patients using their Out-Of-Network benefits, for preventive and diagnostic services there will often be either a $0 or very minimal out-of-pocket cost. A lot of our patients have out-of-pocket costs between $20 and $40, but still prefer to come to us due our great service.
Our goal is to help you maximize your dental insurance benefits. And as a courtesy, we are happy to bill your dental plan for services. When we call on your insurance and verify benefits, it is not a guarantee of payment by the insurance company and may vary according to your individual plan when the actual claim is submitted.
Please understand that we file dental insurance as a courtesy to our patients. We do not have a contract with your insurance company, only you do. Although we are happy to assist you in answering basic questions about your coverage, it is ultimately up to you to understand your policy.
Don’t have dental insurance? Learn more about The Duffel Dental Care Plan!