Communicating a change in network status to your patients is crucial for maintaining trust and ensuring a smooth transition. A well-crafted out-of-network letter should clearly explain the situation, outline the potential impact on their insurance coverage, and provide options for continued care. Transparency and empathy are paramount; patients need to understand *why* the change is happening and *how* it affects them. A proactive approach, addressing potential concerns before they arise, will significantly contribute to positive patient relationships.
This article provides 14 sample letters designed to help you navigate this delicate situation. Each sample is tailored to a slightly different scenario, allowing you to choose the one that best reflects your practice and your patient base. From letters focusing on cost considerations to those emphasizing continued quality of care, these templates offer a starting point for crafting your own personalized communication. Remember to adapt the language to fit your specific circumstances and always prioritize clear, concise, and compassionate messaging.
Sample Patient Letters: Out-of-Network Transition
Sample Letter 1: General Announcement
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
I am writing to inform you that [Practice Name] will be transitioning out-of-network with [Insurance Company Name(s)] effective [Date]. This decision was made after careful consideration and allows us to continue providing the highest quality dental care you deserve.
While we will no longer be contracted with [Insurance Company Name(s)], you can still receive treatment at our office. However, your insurance benefits may be different. We encourage you to contact your insurance provider to understand your out-of-network coverage. We will continue to file claims on your behalf.
Please do not hesitate to contact our office with any questions or concerns. We value your trust and look forward to continuing to serve your dental needs.
Sincerely,
[Dentist Name]
Sample Letter 2: Emphasis on Quality of Care
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
This letter is to inform you of a change in our network status. Effective [Date], [Practice Name] will no longer be in-network with [Insurance Company Name(s)].
This decision, while difficult, allows us to maintain our commitment to providing the highest standard of dental care. We believe in investing in the latest technology, continuing education for our staff, and spending the necessary time with each patient to ensure optimal oral health. Being out-of-network allows us the flexibility to do so.
We understand this may impact your out-of-pocket expenses. We will gladly file claims to your insurance company, and we encourage you to verify your out-of-network benefits. We also offer flexible payment options to make quality dental care accessible. Please contact our office to discuss these options further.
We value your relationship with our practice and hope to continue serving you.
Sincerely,
[Dentist Name]
Sample Letter 3: Focus on Cost Considerations
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
We are writing to inform you that [Practice Name] will be transitioning out-of-network with [Insurance Company Name(s)] on [Date].
This change allows us to manage our costs more effectively and avoid compromising the quality of care we provide. While we will no longer be contracted with [Insurance Company Name(s)], we will still file claims on your behalf, and you will likely receive reimbursement from your insurance provider according to your out-of-network benefits. We are happy to provide you with a pre-treatment estimate to help you understand your potential out-of-pocket costs.
Please contact your insurance company to confirm your out-of-network coverage. We also offer various payment options, including payment plans, to help manage your expenses. We appreciate your understanding and look forward to continuing to care for your smile.
Sincerely,
[Dentist Name]
Sample Letter 4: Offering Alternative Payment Options
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
We are informing you that as of [Date], [Practice Name] will no longer be in-network with [Insurance Company Name(s)].
We understand this may raise concerns about the cost of your dental care. To help ease this transition, we are pleased to offer several alternative payment options, including extended payment plans, in-house membership plans (if applicable), and third-party financing. We will work with you to find a solution that fits your budget and ensures you receive the dental care you need.
We will continue to file claims on your behalf. Contact your insurance provider to learn about your out-of-network benefits. We are committed to providing affordable and high-quality dental care. Please call our office to discuss your payment options or to schedule your next appointment.
Sincerely,
[Dentist Name]
Sample Letter 5: Addressing Specific Insurance Company Concerns
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
This letter is to inform you that effective [Date], [Practice Name] will no longer participate in the [Insurance Company Name] network.
We have made this decision due to increasing administrative burdens and limitations on treatment options imposed by [Insurance Company Name]. We believe that remaining independent allows us to provide the best possible care for our patients, free from unnecessary restrictions. We are committed to treatment based on your individual needs.
While we will no longer be in-network with [Insurance Company Name], we will still file your claims. We strongly encourage you to contact [Insurance Company Name] to understand your out-of-network benefits. We are here to help you navigate the claims process and answer any questions you may have.
Sincerely,
[Dentist Name]
Sample Letter 6: Continued Filing of Claims
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
I am writing to inform you of a change regarding our practice’s participation in insurance networks. Effective [Date], we will no longer be in-network with [Insurance Company Name(s)]. Rest assured, this does not mean you cannot continue to receive care at our office.
Importantly, we will *continue to file claims on your behalf* with your insurance company. You will be responsible for any difference between our fees and the amount your insurance reimburses. Please contact your insurance provider to confirm your out-of-network coverage and reimbursement rates. We are happy to provide you with a pre-treatment estimate for your planned dental work.
We are committed to making your dental care as seamless as possible. Please don’t hesitate to contact our office with any questions.
Sincerely,
[Dentist Name]
Sample Letter 7: Transitioning to a Fee-for-Service Model
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
This letter is to advise you that effective [Date], [Practice Name] will be transitioning to a fee-for-service model. This means we will no longer be contracted with any insurance companies.
This decision allows us to focus entirely on providing the highest quality of care, using the best materials and techniques, without being constrained by insurance company limitations. Under a fee-for-service model, you will pay for your treatment directly, and we will provide you with the necessary documentation to submit a claim to your insurance company for reimbursement. Your reimbursement amount will depend on your individual policy’s out-of-network benefits. Please contact your insurance provider to confirm these benefits.
We understand this is a significant change. We are committed to helping you navigate this process. Please contact our office to discuss any concerns or questions you may have. We value your relationship with our practice and believe this change will ultimately allow us to provide you with even better care.
Sincerely,
[Dentist Name]
Sample Letter 8: Short and Simple Announcement
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
Please be advised that [Practice Name] will be out-of-network with [Insurance Company Name(s)] starting [Date]. We will continue to file claims for you. Contact your insurer for benefit details.
Thank you.
Sincerely,
[Dentist Name]
Sample Letter 9: Offering a Consultation
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
We are writing to inform you that [Practice Name] will no longer be in-network with [Insurance Company Name(s)] effective [Date].
We understand you may have questions about how this change will affect your dental benefits and out-of-pocket costs. We would like to offer you a complimentary consultation with our financial coordinator to discuss your individual situation and explore your options. Please contact our office to schedule this consultation.
We value your continued trust and are here to assist you in any way we can.
Sincerely,
[Dentist Name]
Sample Letter 10: Highlighting the Benefits of Staying with the Practice
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
We are writing to inform you that, as of [Date], [Practice Name] will no longer be in-network with [Insurance Company Name(s)]. While we understand this may present changes to your dental care expenses, we strongly believe that the benefits of remaining with our practice outweigh the potential cost differences.
Our commitment to providing personalized, high-quality dental care remains unchanged. We utilize the latest technology, prioritize your comfort, and dedicate ample time to each appointment. We believe in building lasting relationships with our patients and providing comprehensive care tailored to your individual needs. We will continue to file insurance claims as a courtesy. We hope you’ll consider the value of continuity of care and the trust you’ve placed in our team.
Please contact our office with any questions you may have.
Sincerely,
[Dentist Name]
Sample Letter 11: Informing Patient of Change But Highlighting Future Relationship
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
This letter is to notify you that effective [Date], [Practice Name] will be transitioning out of network with [Insurance Company Name(s)]. This transition has not been easy to make, but a decision to ensure continuity of a top-tier quality dental services
We recognize that this change might influence your insurance coverage. To help alleviate any concerns and ensure transparency, we highly recommend contacting your insurance provider.
We value you as a patient and we appreciate your business. We look forward to our future relationship.
Sincerely,
[Dentist Name]
Sample Letter 12: Immediate Out of Network Change
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
We are writing to inform you that [Practice Name] has decided to move out of network with [Insurance Company Name(s)] as of today, [Date].
This change provides an opportunity to maintain high end dental work, allowing us to continue investing in the latest technology. This transition has not been easy to make, but will give us the necessary freedom to provide you with top tier quality services.
We value you as a patient and we hope to see you in our office again.
Sincerely,
[Dentist Name]
Sample Letter 13: Special Offer to Assist With Payment
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
I am writing to let you know of an upcoming change regarding [Practice Name]’s insurance status with [Insurance Company Name(s)]. As of [Date], we will no longer be in network with [Insurance Company Name(s)].
To help ease this transition, we are giving you a one time 5% off promotion for your services. As always, we will file claims on your behalf with insurance.
We hope that this adjustment provides you with peace of mind.
Sincerely,
[Dentist Name]
Sample Letter 14: To Help Maintain Premium Services
[Date]
[Patient Name]
[Patient Address]
Dear [Patient Name],
I hope you are well. I am writing to inform you that [Practice Name] will be transitioning out of network with [Insurance Company Name(s)] beginning [Date].
We are grateful for your continued business and we believe in providing you with quality equipment and materials. By transitioning out of network, we can invest in the latest dental technology.
Please contact our office with any concerns or questions you may have.
Sincerely,
[Dentist Name]
Conclusion
Choosing the right out-of-network patient letter is essential for a smooth transition. Remember to customize the samples provided to reflect your practice’s unique circumstances and values. Clear, empathetic communication can strengthen patient relationships during this potentially challenging period, ensuring they feel valued and informed. Prioritizing their understanding and providing support throughout the process will foster trust and encourage them to continue seeking care at your practice.