Important Information Regarding Delta Dental
Delta Dental Out-of-Network Frequently Asked Questions
I understand that Dr. Mike has decided to go out-of-network with Delta Dental…what does this mean?
Through the end of June, Dr. Mike will remain in network with Delta Dental, meaning he has a contract with Delta Dental for negotiated, discounted fees. After that, he will be out of network, and his fees will no longer be set by Delta Dental.
How will Dr. Mike being out-of-network with Delta Dental affect me?
Because Dr. Mike’s fees will no longer be agreed and discounted, he will be charging full price for his services. Following treatment, you will pay Dr. Mike in full for his services. Dr. Mike will then submit a claim on your behalf to Delta Dental after which they will reimburse you directly based on a percentage of what they determine as Usual, Customary, and Reasonable (UCR) fees, which might be lower than what Dr. Mike charges.
Can I still go to Dr. Mike for my dental care?
YES! Being out-of-network does not mean that you cannot still see Dr. Mike for your dental care.
Why is Dr. Mike deciding to go out-of-network with Delta Dental?
Dr. Mike values his Delta Dental patients. However, Dr. Mike’s contract with Delta Dental allows him to charge only a small percentage of his typical fees…currently this is only 30%. Unfortunately, this does not cover what it costs him to provide his services, and he loses money on every transaction with Delta Dental.
Why should I continue to see Dr. Mike as my dentist?
Dr. Mike hopes that, even being out-of-network with Delta Dental, you will continue to trust him for your dental care. Even though your dental care will likely cost more, please discuss with Dr. Mike options for reducing your out-of-pocket expenses. Dr. Mike offers an in-house insurance plan that provides twice-yearly cleanings, and discounts on many of his procedures. And he is always willing to work with you to make your dental care most cost-effective!
Is there anything I need to do?
No…Dr. Mike will handle the submission of your claims following treatment. However, if you have any additional questions or concerns, we recommend you review your insurance plan carefully, ask for a cost estimate for any planned work, consider Dr. Mike’s in-house membership plan, and discuss any concerns with Dr. Mike.