Out-of-network (OON) refers to a claim that is made with a provider that is not contracted with the benefit plan’s insurance provider.
You can find in-network providers though the Beam Find a Dentist Tool.
Out-of-network (OON) claims are covered, but you may pay more out-of-pocket. These claims are paid
out by one of two methods:
- Maximum allowable cost (MAC) - Claim payments are determined by the in-network (INN) fee schedule.
- Usual, customary & reasonable (UCR) - Claim payments are based on the average price for a service in a given geographic area.