Having a packed schedule and high patient demand sounds like a great problem to have — and in many ways, it is. But if your hygiene schedule is booked out 8 months, and you’re struggling to hire additional team members to handle the load, you may be missing a golden opportunity to shift your practice model.

Specifically: Should you go out of network with dental insurance? The answer might be yes, and here’s why.

Overflowing Hygiene = Opportunity, Not Just Stress

A hygiene schedule booked 6 to 12 months in advance is a clear indicator of:

• High patient demand

• Strong patient retention

• Brand loyalty and trust in your care

It also means:

• Patients are willing to wait for you

• Your value as a provider exceeds the perceived value of their insurance network

In other words: you have leverage.

The PPO Profit Problem

If you’re this busy while participating in multiple PPOs, you may be:

• Writing off 30–50% of your fees (ADA & Practice Booster stats)

• Paying higher wages and bonuses just to stay ahead

• Limiting your ability to reinvest in your practice

You're doing more work for less reimbursement, and you’re capped by the PPO fee schedule—not by your value or skill level.

Think Like a Business Owner

If you had a restaurant with a waitlist every night and customers raving about your food, would you keep offering 40% discounts to fill seats?

Of course not. You’d raise prices or improve margins.

In dental terms: Going out of network allows you to do just that.

But Won’t I Lose Patients?

Some patients may leave—but many won’t, especially those already booked out 6–8 months and emotionally connected to your team.

In fact:

• Studies show 60–70% of patients stay with their provider after going out of network if communication is clear and value is emphasized.

• Many patients don't truly understand the “in-network” concept. If you assist them with paperwork and provide great care, they’ll follow you.

Can’t Hire? Stop Trying to Outwork the System

You’re not alone if you're struggling to hire front desk, assistants, or hygienists. The dental labor shortage is real.

If hiring is a challenge, the best solution isn’t to overwork your current team. It’s to see fewer patients at a higher value—and going out of network supports exactly that.

When Going Out of Network Makes Sense:

• Hygiene is booked out 6+ months

• Patients are still asking for appointments despite the long wait

• Your fees are significantly higher than PPO allowables

• You’re struggling to hire or train new team members

• You're producing more but profiting less

Final Thought: Going Out of Network Is Not Going It Alone

Going out of network doesn’t mean abandoning patients or taking a financial leap without a parachute. It means reclaiming control of your schedule, your fees, and your future.

Start by:

1. Analyzing which plans pay the least or cause the most admin friction

2. Developing a communication strategy for patients

3. Considering an in-house membership plan for those without insurance

4. Dropping one plan at a time with careful planning

If you're unsure where to start, I can help you map out a strategy — or recommend services that guide dentists through the PPO exit process step by step. Just ask!

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

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

Websites:
www.VeritasDentalResources.com | www.VerusDental.com