This letter provides a sample template for dentists informing patients of their practice transitioning out of a specific insurance network. Adjust the details to reflect your specific circumstances. Always consult with legal counsel to ensure compliance with all applicable laws and regulations.
[Your Practice Letterhead]
[Date]
[Patient Name] [Patient Address]
Subject: Important Information Regarding Your Dental Insurance Coverage
Dear [Patient Name],
This letter is to inform you of a significant change regarding our participation with [Insurance Company Name] insurance. Effective [Date], our practice will no longer be in-network with [Insurance Company Name]. This means that services provided after [Date] will not be covered under your current [Insurance Company Name] plan at the in-network rate.
We understand this change may cause inconvenience, and we sincerely apologize for any disruption this may cause to your dental care. This decision was made after careful consideration and was not taken lightly. [Optional: Briefly and professionally explain the reason for leaving the network. Keep it concise and avoid negativity. Examples: "Changes in the reimbursement rates made it unsustainable to remain in-network," or "We're focusing our efforts on providing the best possible patient care, and this transition allows us to do so more effectively."]
What this means for you:
- You will be responsible for the full cost of your dental treatment at the time of service. We will provide you with a detailed breakdown of charges before any procedures are performed.
- You can still submit your claim to [Insurance Company Name] for out-of-network benefits. However, your out-of-network coverage likely involves higher patient responsibility and a significantly reduced reimbursement compared to in-network benefits. Please contact [Insurance Company Name] directly at [Phone Number] or visit their website at [Website Address] to understand your out-of-network coverage details.
- We will continue to provide you with high-quality dental care. Our commitment to your oral health remains our top priority.
Frequently Asked Questions:
Will you still accept my insurance?
While we are no longer in-network with [Insurance Company Name], we will still gladly accept payments from your insurance company for out-of-network benefits. However, keep in mind that you will be responsible for the difference between our fees and the amount your insurance reimburses. We are happy to help you understand your estimated out-of-pocket costs.
What are my options?
You have a few options:
- Continue receiving care at our practice and pay the full cost at the time of service.
- Find an in-network dentist with [Insurance Company Name].
- Consider a different dental insurance plan that includes us as an in-network provider.
We encourage you to contact our office at [Phone Number] or reply to this email to discuss your options and any questions you may have. We value your continued trust and look forward to assisting you with your dental needs.
Sincerely,
[Your Name] [Your Title] [Your Practice Name] [Your Phone Number] [Your Email Address]
Important Note: This is a sample letter and should be reviewed and customized by legal counsel to ensure compliance with all applicable regulations. Consider adding information about payment plans or financing options if available.
