Let’s talk about the great mystery of modern dentistry, the vanishing dental dollar.
How is it that in New York City, a crown can cost $2,500 when you set your own fee, yet insurance “allows” you to collect somewhere between $800 and $1,200 for the same exact tooth, same exact doctor, same exact crown, and same exact rent that costs more than a Tesla payment?

Welcome to the Twilight Zone of dental insurance economics, where inflation exists everywhere except in your PPO fee schedule.

The Cost of Doing Dentistry Has Gone Up — Way Up

In the last few years, the cost of running a dental office has skyrocketed:

Lab fees? Up.
Payroll? Way up.
Supplies? Forget it, gloves cost more than crypto now.
Rent and utilities? Don’t even get started.

Meanwhile, your in-network fees have been chilling in 2010 like nothing’s changed.
You’re out here paying 2025 prices with 2010 reimbursements. If that’s not financial time travel, what is?

When “Usual and Customary” Becomes “Unusually Low”

Let’s get real, there’s nothing “usual” or “customary” about insurance fees anymore.
Your UCR (Usual, Customary, and Reasonable) fees, the ones you set, reflect the real cost of providing excellent care in today’s economy. They evolve with inflation, your experience, and your commitment to quality.

Insurance fees, on the other hand, are like that one friend who still thinks gas is $2 a gallon and Netflix is $7.99. They’re frozen in time.

And here’s the dangerous part: when fees stay stagnant while costs keep climbing, something has to give.
It’s not just unsustainable, it’s dangerous for the profession.

The Breaking Point (a.k.a. The Great Dental Meltdown)

Dentistry is a business, not a charity. You can only absorb rising costs and low reimbursements for so long before something breaks.
And unfortunately, when the system gets this tight, history has shown what happens next:

More cutting corners just to stay profitable.
More burnout from overproduction.
And yes, even more fraud, as desperate offices try to survive impossible margins.

That’s not cynicism, it’s reality. A system that pays less than it costs to perform the work will eventually collapse or corrupt.
And spoiler alert: neither outcome helps patients.

Why PPO Fee Negotiations Matter More Than Ever

The good news? You don’t have to take it lying down.
Insurance plans can increase your reimbursements, they just don’t do it automatically. You have to negotiate.

Think of PPO fee negotiations as your financial hygiene appointment, something you should be doing regularly, not once every 10 years when your hygienist (or accountant) reminds you.

At Veritas Dental Resources, we’ve helped dentists across the country increase their PPO fees by 10–40% or more, often without changing a single contract. That’s like getting a raise without adding an extra patient or working an extra day.

The Inevitable Future: Going Out of Network

Now, let’s talk strategy.
If you think PPO negotiations are step one, going out of network is step two (and no, it’s not career suicide).

Here’s the truth no insurance plan wants you to know:
When more doctors join insurance networks, fees go down.
But when more doctors leave those networks and go out of network, fees mysteriously go up.

It’s almost as if, gasp, insurance companies respond to supply and demand.

So, when you see thousands of dentists finally saying, “You know what, I’m done working twice as hard for half the pay,” the system starts to rebalance itself.

You Can’t Fix the System Alone — But You Can Fix Your Situation

It’s illegal for dentists to collectivize or negotiate together (thanks, antitrust laws), but that doesn’t mean you’re powerless.
Each practice can, and should, have a PPO negotiation strategy.

That’s where having a partner like Veritas Dental Resources makes all the difference. We know the loopholes, the leverage points, and the little-known ways to get insurers to pay more, legally, ethically, and effectively.

Because if there’s one thing we’ve learned after working with thousands of offices nationwide, it’s this:
Dentists don’t go broke because they’re bad clinicians.
They go broke because they never had someone fighting for their worth.

Quick Recap

Your standard fees are going up, as they should.
Insurance fees are staying flat, as they always do.
The gap between reality and reimbursement is growing wider every year.
Regular PPO fee negotiations are your best defense.
Going out of network might just be the key to saving your practice (and your sanity).

The moral of the story?
You can’t control insurance companies, but you can control your strategy.
And that’s where the real power lies.

Ready to stop letting insurance dictate your worth?
Let’s talk.
👉 Book a PPO Fee Consultation with Veritas Dental Resources

Because it’s time your fees reflect your value, not the insurance company’s spreadsheet.

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