We can work with any insurance plan that allows you to choose your dentist, typically referred to as a PPO plan. If your insurance plan requires you to use a specific dental office, which is common with HMO policies, we won’t be able to utilize that insurance.

If you do have a PPO policy, we can still submit all dental claims on your behalf and strive to help you maximize your insurance benefits. If you have any questions about your specific plan or need assistance with claims, we’re here to help and we are very good at this!

We are not in-network with any insurance companies, so all of our patients are considered out-of-network. This means that to maximize your insurance benefits with us, your insurance needs to be a PPO policy.

If you don’t have a PPO plan, or choose not to use insurance, we offer an in-office membership plan. By signing up for the Titus Dental membership, you’ll receive discounts on restorative work and other benefits. This plan is designed to provide value for self-pay patients. Make sure you ask us about our membership plan if this sounds like a good fit.

We are not “In-Network” because we do not believe that being in network is what is best for our patients. By not being restricted by insurance company policies, we can focus on delivering personalized and comprehensive treatments that are tailored to each patient’s unique needs, rather than adhering to the constraints set by insurance networks.

Since we are an out-of-network dental office, it can be challenging to determine exactly what your insurance will cover. Insurance plans use two main components to determine payment: the percentage of coverage and the allowed amounts. 

Percentage of Coverage: This is the percentage your insurance company states they will cover for various procedures. For example, they might say they cover 100% for preventive procedures, which sounds great. However, this percentage applies to the  amount the insurance company allows rather than our actual charges.

Allowed Amounts: These are the fees set by the insurance company that they agree to cover. Unfortunately, insurance companies don’t always share these allowed amounts with us directly. For instance, if we charge $100 for a cleaning but the insurance company’s allowed amount is only $50, insurance will cover 100% of their allowed amount, which means you still owe the difference of $50.

This discrepancy can make insurance coverage complex and sometimes unpredictable. We do our best to minimize any surprises and to help you understand your potential out-of-pocket costs. However, insurance plans often have limitations and may not cover the full amount of your charges no matter if you are in network or out of network. We can submit a Pre-Treatment Estimate (PTE) to your insurance company. This process informs them of the recommended treatment and allows them to provide an estimate of what they will cover. Receiving this estimate can help you better understand your potential out-of-pocket costs.

Insurance companies often discourage patients from going out-of-network because it benefits them financially. When you visit an in-network provider, the insurance company has negotiated lower rates for services, which helps reduce their overall payout. Since insurance companies make money by selling policies and then partnering with dental offices that accept these lower rates, they have a financial incentive to steer patients toward in-network providers.

Additionally, by promoting in-network options, insurance companies can encourage higher patient volumes at these practices. This can sometimes lead to longer wait times and a more impersonal experience, as the focus shifts to managing a higher volume of patients.

At our practice, we prioritize providing high-quality, personalized care without the constraints of insurance network limitations.

Insurance companies often send letters indicating that our fees are higher than the Usual, Customary, and Reasonable (UCR) rates as part of their standard procedure to inform you about the differences between their allowed amounts and our charges. The UCR rates are estimates based on what they deem typical for similar services in your area, but these estimates may not always align with the fees set by our practice.

Our fees reflect the quality of care, expertise, and personalized treatment we provide. Insurance companies may set lower allowed amounts that do not fully cover these fees. This discrepancy can sometimes make it seem like our charges are higher, but it’s important to understand that the UCR rates are just benchmarks and may not always represent the full range of fees for specialized or high-quality care.

Choosing an out-of-network dental office can be a smart decision for several reasons. When a dental office agrees to in-network fees, they have to accept reduced rates determined by the insurance company. These reduced fees can put a strain on the practice, affecting their ability to cover overhead costs while maintaining the quality of care.

In contrast, as an out-of-network office, we set our fees based on the cost of using high-quality materials and hiring skilled professionals. This approach allows us to offer the best possible care without having to cut corners or compromise on the quality of our services.

Moreover, by not being bound by insurance network constraints, we can get you on our schedule more quickly and efficiently. We provide straightforward, transparent pricing without needing to add extra charges to make up for reduced fees that in-network agreements might require.

Our goal is to focus on what’s best for our patients, rather than adhering to insurance company rates. This often results in better care and can save you money in the long run, as we are not forced to make compromises that might not be in your best interest.