Quick Bites for your Dental Office

Step-By-Step To Go Out Of Network

Ashley Bond Season 1 Episode 35

Resources from today's episode:
Front Office Coaching: http://www.firstimpressiondentalcoaching.com
Smile Advantage-Dental Care Plan: https://mysmileadvantage.com
Going out of network letter/scripts:  email me Ashley.bond@bonddentalbilling.com

How to tell patients you are going out of network?

First, be very up front with your patients. I recommend sending a letter before the move because chances are the insurance company WILL send them notification prompting them to leave your practice. Get in front of it by sending them a letter discussing that they CAN stay and a lot of times the difference between in and out of network rates are small. Be willing to do a breakdown of benefits for each patient before they come in and try to give them the best estimate you can. You can really prompt your in house membership plan which may save the patient money and keep them committed to your practice. Especially patients who do not have a lot of treatment, this could be a perfect solution. It's super easy now to implement an in house membership plan. I recommend a company called Smile Advantage. Instead of charging your office for each patient's visit, they help your office set up a DIY membership plan. They help with the tracking and marketing for a low monthly fee.


It should be a methodical dropping. Not a quick thing. 

  1. Get in contact with and invest in training for your staff- front office coaching - Kortney LeDuc with first impression dental coaching
    1. Answer questions like why are you going out of network?
    2. How will it change my costs?
    3. Increase Customer Service 
    4. What to say when new patient call
      1. I have some scripts and a letter for your team- send me an email at ashley@bonddentaconsulting.com and I would be happy to share them with you
  2. Get in contact with a company to help you with your in-house membership plan like Smile Advantage or start one yourself. Create that option for patients
  3. Call the insurance company and ask the steps to go from in network to out of network
  4. Send a letter to your patients BEFORE you submit the paperwork needed by the insurance company. I have a free example; just email me.
  5. Submit the necessary paperwork to go out of network- this can take months to process
  6. Have a team members designated to make sure the transition with the insurance company stays on track- they will attempt to delay it