(Hint: When your hygiene schedule looks like Taylor Swift concert tickets… sold out for months.)

Dentists often feel like they’re running a high-powered law firm—except instead of defending Fortune 500 companies, you’re defending molars against plaque and insurance fine print. Every operatory is filled, phones are buzzing like Wall Street trading floors, and your clinical team is working with the precision of a surgical strike team. On the surface, everything looks like success. But then you look at the numbers and realize: you’re diagnosing, planning, and presenting excellent care all day long… and still taking home less than feels fair.

And that, my friends, is the first neon sign flashing: “It might be time to consider going out of network.”

The Two Big Red Flags

1. Your hygiene appointments are booked out 4+ months.

Sure, that sounds like a brag-worthy problem. (“We’re so popular we should get a blue checkmark!”) But in reality, being booked solid for months doesn’t mean you’re thriving—it often means you’re undercharging. Translation: your in-network insurance fees are keeping you busy but broke.

2. You have too many patients, not enough profit.

If your waiting room looks like a Black Friday line at Best Buy but your bank account looks like a garage sale cash box, you’re working harder than ever… for less. Insurance is winning. You? Not so much.

But Wait—Don’t Jump Ship Without a Compass

Here’s where many dentists make the mistake: they get fed up, cut contracts, and then wonder why their schedule looks like a ghost town the following month. Going out of network isn’t a rash “I quit” moment—it’s a strategic business move that requires analysis:

• Run a fee schedule analysis. Are you actually charging what you’re worth, or is your UCR fee schedule basically the Costco bargain bin?

• Calculate patient attrition impact. How many patients might leave if you drop Plan X? How many need to leave so you can focus on profitability instead of hamster-wheeling through low reimbursements?

• Know your payer mix. If one insurance company makes up 70% of your practice… tread carefully. If they make up 10%? Kick that PPO to the curb with a smile.

Experts (and your friendly neighborhood consultants at Veritas Dental Resources) recommend that you:

• Review collections vs. write-offs for each PPO.

• Model “what-if” scenarios to estimate post-termination revenue.

• Consider staff bandwidth—your team needs to be ready to handle out-of-network claims, explanations, and the occasional patient meltdown.

The Patient Side of the Story

Here’s the truth: patients fear “out of network” like it’s a horror movie title. The key? Reframe the language.

Instead of: “We’re going out of network.”
Say: “We’re becoming a non-restricted provider (out of network).”

Why? Because “non-restricted” means exactly that—you’re free from unnecessary insurance limitations that water down treatment quality. These restrictions are designed to make insurance companies money, but they stress out doctors who just want to provide the best care possible. By stepping into a non-restricted (out of network) status, you protect your standards of care and put patients’ health ahead of corporate spreadsheets.

The Best Practices:

• 4–6 months’ notice. Don’t blindside your patients like a bad first date. Talk to them early and often.

• Explain the why. Insurance restrictions threaten quality care. You’re protecting patients by becoming non-restricted (out of network).

• Reassure benefits. Most PPO patients can still use their benefits with you. You’ll still file claims. You’ll still fight insurance dragons on their behalf.

And when the time comes, send them a classy letter, like this gem:
“Our decision to become a non-restricted provider (out of network) was largely due to the difficulty we had sustaining high-quality dentistry under the rules and regulations of insurance carriers. This change ensures that you receive the best care we know how to offer.”

Sarcasm Corner

If you’re still on the fence about going out of network, ask yourself this:

• Do I want to keep working twice as hard for half the money?

• Do I enjoy getting audited by insurance companies who think they know more about dentistry than me, despite never having flossed properly in their lives?

• Do I believe my clinical judgment should be dictated by a cubicle-dweller named Steve with a spreadsheet?

If you answered yes to any of the above, congratulations—you’re the perfect in-network dentist.

Final Word of Encouragement

Going non-restricted (out of network) isn’t about abandoning patients. It’s about abandoning insurance companies that hold your career hostage. Done right—analyzed, strategized, and communicated with grace—you’ll actually earn more, see patients who value your work, and reclaim your sanity.

Remember: your patients didn’t choose you because you’re “in-network.” They chose you because you’re you.

Benjamin Tuinei

Founder – Veritas Dental Resources, LLC

📞 888-808-4513

Services: PPO Fee Negotiators, PPO Fee Negotiating, Insurance Fee Negotiating, Insurance Credentialing, Insurance Verifications

Websites: www.VeritasDentalResources.com, www.VerusDental.com