Insurance and billing
Out-of-network
Also called non-participating provider
A dental office that has no contract with the patient's plan, so the plan's rules and payments may differ.
An out-of-network office has no agreement with the patient's insurer. The plan may still pay a portion, often based on its own fee level, and the office can often bill the patient the remainder. Patients may owe more than at an in-network office. Explain this before treatment and review payment options. Some offices ask patients to pay at the visit and then file the claim for reimbursement.
Example at the front desk
We're out of network with her plan, so she'll pay today and we will submit the claim for her.