Dental Insurance Coverage; the difference between in-network and out of network

Updated: May 20

One of our most common questions is, 'Does your office accept my dental insurance?' The answer is most of the time, yes!


We are an "in-network" provider for Delta Dental.  However, we still accept and file claims to almost all the other insurance companies at the out-of-network level to provide you with the best possible coverage available. 


Insurance plans not covered at our office include:

BadgerCare

Medicare/Medicaid

American Dental Plan

Forward Health

GHC

Physicians Plus


In-Network Coverage VS. Out-of-Network Coverage:


We check on your insurance coverage and submit your benefits on your behalf as a courtesy. You are still responsible for understanding and knowing your benefits.


In-Network–A provider has signed a contract agreement with the insurance company to provide their insured patients a “discounted” rate. The primary advantage of using an “in-network” provider is that you receive this negotiated or discounted rate for their services, and your insurance generally picks up a larger portion of the bill than with an out-of-network provider.


Out-of-Network- A provider which has not contracted with your insurance company for reimbursement at a negotiated rate. Some plans, like HMO or DMO plans, do not reimburse out-of-network providers at all, which means that as the patient, you would be responsible for the full amount charged by your doctor. Other plans offer coverage for out-of-network providers, but your patient responsibility may be higher than it would be if you were seeing an in-network provider.


Please keep in mind that there are thousands of different insurance plans all with different stipulations for services.


Benefits Check


If you would like to know how much your insurance will pay at our office, call our front desk at 608-338-0629.  We will require some basic information from the policy holder (name, birthday, insurance company, group number, and ID number or social security number) in order to complete the complimentary benefits check.  If you are listed as a dependent on the policy, we will need the insurance holder's information.  Once we have your specific coverage information, we will call you back with a brief overview.


No insurance?  No problem! 


Financing Option:

We offer a 12 month interest-free program available through CareCredit. Please call us to discuss whether this financial plan is available to meet your needs.


Available Discounts:

We also offer a discount for same-day payment with cash or check.  Individuals 64 and younger will receive a 5% discount off their bill while individuals 65+ receive a 10% discount.  This discount cannot be in conjunction with an insurance policy or a finance plan. 


Referral Program:

Learn how you can earn credit towards future treatment with our referral program


Wellness Program:

Join our Wellness Program and pay a monthly membership fee that covers preventative care and discounted future treatment.  This program cannot be in conjunction with an insurance policy or a finance plan. Some exclusions may apply.   


Payment Options:


We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered.  Payment for a sedation appointment is due in full one week before the appointment date in order to reserve it in the Doctor's schedule.  Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated.


We accept Visa, MasterCard, Discover, and American Express.

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344 South Yellowstone Drive

Madison, WI, 53705

Monday - Friday

7am - 3pm

 © 2020 Madison No Fear Dentistry 

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