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"What insurance do you take?" It's one of the most common questions we hear at Tanglewood Dental Associates, and our answer might surprise you. While most dental practices rush to contract with insurance networks, we've made a deliberate choice to remain non-contracted—and here's why that decision actually benefits your oral health and wallet.
In an era where insurance companies are paying less than ever—some as little as $37 for a professional cleaning—many contracted providers face an uncomfortable reality. They must either compromise on care quality or find creative ways to increase revenue. We've witnessed patients return to us with extensive treatment plans from other offices, questioning whether all that work was truly necessary.
At Tanglewood Dental Associates, we believe your smile deserves better than insurance-driven dentistry. In this comprehensive guide, we'll walk you through exactly how our non-contracted approach works, why it often costs less than you'd expect, and how we make premium dental care accessible through transparent pricing, flexible payment plans, and alternative funding options like HSA and FSA benefits.
Discover how choosing quality over convenience can transform not just your dental experience, but your long-term oral health investment.
When Dr. Lawnin established Tanglewood Dental Associates' approach to insurance, the decision wasn't made lightly. "This practice has been non-contracted for years," Alice explains. "We've been non-contracted for over 20 years. We were in network with a couple – Delta was one – and you just end up writing a lot of money off."
Think of insurance contracts like this: imagine you're a skilled craftsman who normally charges $100 for your work, but a large company offers to send you customers—with one catch. You can only charge $50 for the same quality work, and you must "write off" the difference. This is exactly what happens with dental insurance contracts.
"When you participate with an insurance company, your fee may be a hundred dollars, but because you're contracted, they're only going to pay 100% of $50. So you have to write off that other 50," Alice reveals. For many practices, this creates an impossible choice: compromise on quality or find other ways to make up the revenue shortfall.
The situation has only worsened in recent years. "I've noticed it more after COVID honestly," Alice notes. "We received an insurance check and they paid $37 for a cleaning, and 20 something for an exam." When insurance reimbursements barely cover basic overhead costs, practices face mounting pressure to cut corners or increase volume dramatically.
This pressure creates a troubling dynamic in many contracted practices. "We have patients that come back to us and ask us to do the exam to see if that's really necessary," Alice shares. "They've been diagnosed and they have these long treatment plans, and they're trying to find any and everything that they can, even if something may not really be needed."
These aren't isolated incidents. Alice continues, "There are times that some of the treatment is – I'm not gonna say it's necessary, but they don't see the same treatment needed." When practices must compensate for artificially low reimbursement rates, the temptation to over-diagnose becomes a business necessity rather than a clinical decision.
By remaining non-contracted, Tanglewood Dental Associates can focus on what's truly best for each patient's oral health, rather than what's best for the practice's bottom line under insurance constraints.
The phrase "non-contracted" often triggers anxiety, but the reality is far more patient-friendly than most people realize. "We're not contracted with any insurance plans, but we do accept policies that pay out of network," Alice clarifies. "If you have a policy that has out of network benefits, then we accept it and we can file it."
The key lies in understanding your specific insurance type. "When they have a policy that says PPO, it's a preferred provider organization. That means you have that option to go to any doctor of your choice, any doctor that you prefer, and you still have some coverage," Alice explains.
Most dental insurance plans today are PPO plans, which means you're likely already covered for non-contracted care. The difference isn't whether you're covered – it's how much you'll pay directly.
"Because we're non-contracted, their insurance may not pay our full fee," Alice honestly explains. "But we'll file it and the difference, then, is billed to them." This transparency means no surprise bills or hidden charges – you'll know exactly what to expect before treatment begins.
For many procedures, the additional cost is smaller than patients anticipate, especially when considering the quality of care and materials used. "We have a lot of patients that pay out of pocket," Alice notes, referring to the practice's clientele who prioritize quality over insurance constraints.
One common concern disappears immediately: "We submit, I would say 98, 99% of people that have insurance. We submit all of them," Alice assures. You won't need to navigate insurance paperwork or chase down reimbursements – the practice handles all filing and communication with your insurance company.
This comprehensive approach means you receive the benefits of premium dental care without the administrative headaches often associated with non-contracted providers.
Navigating dental insurance can feel overwhelming, but understanding your specific benefits helps you make informed decisions about your oral health care.
"When you have a policy that has out of network benefits, then we accept it," Alice explains. The key is understanding that non-contracted doesn't mean no coverage – it means different coverage terms.
Most insurance plans cover non-contracted providers, but at different percentages than contracted providers. Your plan documents will specify your "out of network" benefits, which typically include:
One advantage of being non-contracted becomes clear when you understand insurance downgrades. "Insurances downgrade your posterior white fillings – a lot of them downgrade that to an amalgam charge," Alice reveals.
This means even contracted providers face insurance limitations. When you choose tooth-colored fillings, many insurance plans only reimburse at the rate for old-fashioned metal fillings, regardless of whether your dentist is contracted or not. At least with a non-contracted provider, you know upfront what you're paying for quality materials and care.
For orthodontic treatment, insurance coverage follows specific patterns. "Most times it's 50%, and they have like a maximum. Some people have a $1,000 maximum, some people have $3,000, I've even seen a $5,000 max on an ortho plan," Alice explains.
Understanding your orthodontic lifetime maximum is crucial for planning treatment, regardless of whether you choose a contracted or non-contracted provider. "Their maximum will go farther if they go in network," Alice notes, but the quality and personalized attention may justify the additional investment.
Premium dental care doesn't have to strain your budget. Tanglewood Dental Associates offers multiple pathways to make exceptional oral health care accessible, from tax-advantaged health accounts to flexible financing options.
Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) represent one of the most underutilized benefits for dental care. "HSA is a health savings account card which they get from their employer, and they get a certain amount that they can use towards dental, medical, any kind of health expenses," Alice explains.
The beauty of these accounts lies in their tax advantages and broad dental coverage. "Most of the things that are needed like if you need a crown or filling, it's usually because you have decay. So if anything that's necessary" qualifies for HSA/FSA coverage, Alice notes.
Here's what typically qualifies for HSA/FSA coverage:
However, purely cosmetic procedures like teeth whitening or veneers for aesthetic purposes alone typically don't qualify. "No cosmetic procedures are generally not covered – plastic surgery, Botox, teeth whitening, if you're getting veneers just for cosmetic reasons," Alice clarifies.
Understanding the difference between these accounts can save you money. "The HSA, they do not expire. Any unused funds in your HSA rollover," Alice explains. "The FSA is, you lose it if you don't use it."
This makes HSAs particularly valuable for planning larger dental treatments, as unused funds can accumulate over time. FSAs require more strategic timing but offer immediate tax savings for planned procedures.
One significant advantage patients often overlook is the ability to combine benefits. "Yes, they can use their insurance and their HSA for the same procedure," Alice confirms. This means you can:
This strategy works particularly well for necessary treatments that qualify for both insurance coverage and tax-advantaged account usage.
For larger treatments, Tanglewood Dental Associates offers carefully selected financing partners. "We have used Cherry for the bigger cases, and we've used CareCredit," Alice reveals.
Cherry Financing:The practice favors Cherry for several compelling reasons, including better terms for both the practice and patients. Cherry offers:
CareCredit:While available for smaller treatments, the practice notes some limitations with CareCredit due to higher fees and shorter optimal payment terms.
For patients who prefer direct arrangements, the practice offers streamlined in-house financing. "For Ortho, we normally take half down, and then the remaining balance we break up into six months monthly payments," Alice explains.
The system works seamlessly through automated monthly charges, eliminating the hassle of remembering payment dates. The practice shows flexibility for special circumstances while maintaining clear expectations.
Understanding why Tanglewood Dental Associates chooses to remain non-contracted reveals important truths about how insurance affects dental care across the industry.
"We have patients that come back and ask us to do the exam to see if that's really necessary," Alice shares, referring to extensive treatment plans from contracted offices. This reflects a concerning trend where practices feeling pressure from low reimbursement rates may recommend more treatment than truly necessary.
"There are times that some of the treatment is – I'm not gonna say it's necessary, but they don't see the same treatment needed," Alice explains. When Dr. Lawnin examines patients who've received extensive treatment recommendations elsewhere, he often finds more conservative approaches are appropriate.
Insurance constraints don't just affect treatment recommendations – they also impact material choices. Even when patients want modern, tooth-colored fillings, "insurances downgrade your posterior white fillings – a lot of them downgrade that to an amalgam charge," Alice notes.
This means contracted providers may face pressure to use older materials to meet insurance reimbursement rates, or patients end up paying the difference anyway – but without knowing upfront what that difference will be.
When reimbursement rates drop to $37 for cleanings, practices face impossible math. They must either see dramatically more patients per day, find additional revenue sources, or provide care that matches the reimbursement level. None of these options serve patients' best interests.
"Dr. Lawnin probably wouldn't be able to – his overhead is expensive," Alice explains. "You really would have to have a packed schedule, and a lot of these offices that are in network, they charge out for everything. They look for things to charge out."
Armed with understanding about how insurance truly works in dentistry, you can make better decisions about your oral health care.
If you're currently seeing a contracted provider, consider asking:
Before assuming you need a contracted provider, verify:
"We have patients try to go in network, and they return to us because the quality isn't always the best," Alice shares. When considering dental care, think beyond immediate insurance savings to long-term oral health outcomes.
Quality dental work lasts longer, requires fewer repairs, and contributes to better overall health. The small additional investment in non-contracted care often proves more economical over time when you factor in durability and reduced need for retreatment.
Understanding Tanglewood Dental Associates' approach to insurance reveals a fundamental truth: when you prioritize quality care over insurance constraints, you're investing in more than just your smile—you're investing in your long-term health and confidence. We've explored how our deliberate non-contracted status protects you from insurance-driven dentistry, how PPO plans still provide meaningful coverage for our services, and how multiple payment solutions make premium care accessible.
The key insight is clear: transparent treatment recommendations, quality materials, and honest communication create better outcomes than the compromised care often found in insurance-driven practices. Whether you're maximizing HSA benefits, exploring financing options, or understanding your specific insurance coverage, the path to exceptional dental care is more accessible than you might expect.
At Tanglewood Dental Associates, we've spent over 20 years proving that quality care and insurance benefits aren't mutually exclusive. Our comprehensive approach to insurance filing, benefit verification, and alternative payment options ensures that your oral health goals align with your financial planning.
Ready to experience the difference? Call us at 713-784-2952 to schedule your consultation. We'll verify your insurance benefits, explain exactly how your coverage works with our services, and create a personalized treatment plan that prioritizes your oral health without compromising your financial comfort. Your smile deserves nothing less than exceptional care—and we're here to make it happen.
Clear, honest answers to the dental questions you’ve been wondering about, because understanding your care shouldn’t be complicated.
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