It’s possible they are no longer preferred providers with your insurance plan, so aren’t covered like they used to be.

"Preferred provider" is a nebulous term to me, from the standpoint of the dentist. Maybe we're saying the same thing, let me say it differently:

It's very possible that the newer dentists have chosen to not accept insurance. That's not uncommon. So whether "preferred" or not, if their fee for something is 10X, the patient owes them 10X. They bill the insurance company as an accomodation and if its agreed reimbursement for that service is 8X, the patient owes the 2X difference. The choice to accept insurance or not is often a dentist by dentist choice, not an office wide choice.

A successful and well run dental practice can earn the owner 35% of billings overall, some more and many less. Imagine that offering a 15% or 20% discount to patients with insurance can cut the dentist's income more than in half if those time slots could otherwise be filled with patients who will pay full charges.

Basically. When we use dentists that are “preferred” by our in company, we pay less, they get less, and they agree to a set charge. When we use other providers, our insurance company still pays the set price, our percentage increases, and the provider is paid more.

It is likely in the provider’s best interests to choose to not take insurance.

"It is likely in the provider’s best interests to choose to not take insurance."

Only if they think they can fill the time slots with full fee paying patients. When slotting in to an existing practice, there can be patient attrition of those not wanting to pay more. And the opposite is true, as in other businesses - you get more customers (patients) and more revenue by charging less but in doing so, you may or may not earn more net income.

Say you're looking for a job - you find two. Identical companies, identical jobs, identical co-workers and identical circumstances in all respects. One pays 30% more than the other. Which one are you going to take? Is there something wrong with you taking the higher paying job because "it is in your best interest"?

Around here, most are not taking dental insurance anymore, especially when they take over an established practice. Well, they take insurance, but they aren't "preferred".

Always, just go to your dental insurances web site. In simple uncomplicated terms. If they are preferred providers then you should not be billed (unless it isn't a covered service or you have a copay,deductible, or percentage split for the service). If they are not preferred providers then they can bill you.