Frequently asked questions

PPO - In or Out of Network?

In our clinic, new customers often ask: "Is your clinic in the network of insurance companies?" And our answer is: "It's a PPO out-of-network insurance plan, but we have partnerships with all dental insurers in the United States." ”

In fact, many people do not know the PPO plan and insurance declaration process, and they will not deliberately understand the differences, they will think that the services provided by the outside dentist are equivalent to zero insurance, or the quotation is very different.

PPO is an abbreviation for Preferred Service Provider Organization. PPO plans accept both "preferred service providers" (on-line clinics) and medical claims from non-preferred service providers (out-of-network clinics), and the vast majority of PPO plans will cover treatment provided by out-of-network clinics.

Dentists in the network contract with dental insurance companies that promise to charge a fixed fee for certain services, which is usually much lower than what any clinic is willing to charge. So why are these dentists willing to charge so little? Because insurers claim that dentists in the network attract more customers, ideally, increasing the number of patients can compensate for lower revenue (quantity over quality).

Discounts given by in-network dentists may benefit patients' wallets, but they may also force dentists to use lower-grade products on materials that patients cannot see and understand. For example, general dental treatment must obtain materials (such as fixtures, crowns, dentures, bridges, etc.) from dental laboratory OEM services, and general patients pay part of the cost to these laboratories through dentists, but the dentists in the network must bear the cost of these laboratories themselves, so the dentists in the network may choose low-cost laboratories, thus reducing the price of the product, but the quality is unknown. To consider the use of inexpensive materials for cost, patients may have installed cheap crowns or dentures from in-network dentists, resulting in higher defective crowns or dentures or shorter lifespans.

This happens in almost every area of dentistry. In-network dentists struggle to make ends meet and decide their pricing in a maze of contracts from different insurance companies, limited to pricing, they have to make sacrifices in costs and materials, leaving patients with unpredictable worries and consequences. This is why many in-network dentists move off-site, as they realize that staying in-network can negatively impact their clients' dental care and health. After all, failing to provide consumers with the best care and health protection undermines dentist ethics.

Our clinic is not in the PPO network, but we will actively submit insurance applications for customers, the clinic team knows how to work effectively and correctly with insurance companies, so new patients do not need to worry, at the first visit, we will review and explain the insurance content and benefits for you, and submit insurance for you after the consultation.

Dental care is a health investment, your dental care cannot be compromised, if you find an incompetent doctor because of the price and convenience, you cannot expect your teeth to be kept in top condition, and you may invest more time and money in dental care in the future. Often, what seems cheap at first turns out to be much more expensive and a headache.