Question About Braces?

[SandyinMonterey]

We will be moving across country soon. My daughter is 10 months into her first set of braces so we will be needing a new orthodontist. Our realtor recommended 2 in the area, however neither are in network providers on our plan. But plan on having a consultation with at least one out of network. I called our dental provider and got 3 names or orthodontists in my area that are in network. I would only really consider one out of the three. So, my plan is to have a consultation with one out of network and another that is in network. I know that when I consult with the out of network orthodontist, the price I get is what I get. But, with the in network provider, I was told by the insurance company that there is a negogiated rate/fee for the services. Can I ask the in network orthodontist for at the end of the consultation when they give you the cost, if they can give me the "in network cost?' Or thinking or doing it this way, when the in network gives me the total cost, ask then if that is the in network rate? I hope this isn't confusing. Thanks everyone!

 

[tzolkin]

As long as you give them your insurance info, the price they give you should be the "in network rate". The insurance company has already negotiated the rate that they will pay with the in-network providers. This is not something you will need to negotiate for yourself to get a cheaper price.

One way to lower the cost further would be to pay in full. Usually they will offer like a 5-10% discount if you pay in full rather than in monthly payments.

Also, we moved while my daughter was doing her first round of braces and she was able to have the braces removed and her spacer appliance put in before we left. (It was probably only 10 months total in the braces). Then she was done and we didn't have to worry about finding someone who used the same system as our previous orthodontist.

 

[danielw888]

Its not as easy as finding one in network. There are many different types of braces hardware/systems. You have to find an Orthodontist that uses the same system/hardware that your child currently has on their teeth.

Ask them both for a total cost for the remainder of the services they will need to perform between now, and when the braces are removed. Make sure you ask the in-network office to get a quote for the negotiated rate, and you can even ask them to submit the charges for pre-approval so you have a better idea if any insurance issues will come. I mention this due to the fact that they might want to re-do some of the services your previous ortho did, and you insurance might not cover some things if it has noticed it has already paid out for that exact procedure.