Have you ever thought you were out-of-network for a patient’s dental plan, only to later get an explanation of benefits from that plan treating you as an in-network dentist? Instead of charging your full fee like you expected, you were instead subject to the network’s discounted fees. How can this happen?

Dental plans may invoke an affiliated carrier clause (network or PPO leasing) in their signed agreements that makes the dentist a participating dentist for the affiliated carrier even though the dentist did not sign an agreement for the affiliated carrier. Dentists need to know which fee schedule will be used, how they will be notified and which plans they will be participating in. Unfortunately, this information is not always made clear.

Understand what to look for before signing a participating dentist agreement and learn what different contract clauses mean in this helpful guide to third party contract issues. Need more info? Check out this webinar on PPO leasing.