If I had a dollar for every time an insurance rep said,
“These are our standard fees for your geographic area,”
I’d have enough to fund my own PPO.

It sounds official.
It sounds mathematical.
It sounds… inevitable.

But let’s translate it into plain English:

“We’d like to pay you as little as possible, and we’re hoping you won’t question it.”

And the tragedy?
Too many dentists don’t.

The “Standard Fee” Myth

Insurance companies love the word standard. It feels neutral. Fair. Objective.

But in reality, “standard” is often just a starting anchor, and if you don’t counter it with data, it becomes your ceiling.

Let’s break down why this myth is so dangerous.

1. It Ignores Inflation (Like… Entire Decades of It)

Your rent didn’t stay standard.
Your payroll didn’t stay standard.
Your composite, implants, lab bills, and burrs certainly didn’t stay standard.

But somehow… your reimbursements did?

Overhead has climbed steadily for years. Staffing costs alone have skyrocketed post-2020. Yet many PPO fee schedules have barely moved.

When carriers say “standard,” what they often mean is:
“We haven’t updated this in forever.”

And if you accept that without a challenge, you’re essentially agreeing to operate a 2026 practice on 2008 math.

That’s not sustainable.
That’s slow financial suffocation.

2. It Disregards Your Unique Value

Here’s the quiet insult behind “standard”:

It assumes you are interchangeable.

Same training.
Same outcomes.
Same patient experience.
Same efficiency.
Same complication rate.

But you’re not.

You’ve invested years in CE.
You’ve refined your diagnostics.
You’ve built systems.
You’ve trained a team.
You’ve created a culture.

Your dentistry is not “standard.”
It’s earned.

Yet when you accept a fee schedule without a data-backed counter, you’re allowing a third-party payer to assign a generic value to a non-generic skill set.

And that’s not negotiation.
That’s surrender.

3. It Limits Growth and Fuels Burnout

Low fees don’t just reduce profit.

They force behavior.

When reimbursements are compressed, the only way to maintain income is:

• See more patients

• Shorten appointments

• Stack hygiene

• Work longer hours

That treadmill might feel productive… but it’s exhausting.

Burnout doesn’t happen because dentists hate dentistry.
It happens because the math doesn’t work.

When fees are artificially low, volume becomes the only lever.
And volume is a brutal lever.

You didn’t go to dental school to run a hamster wheel.

“Standard” Is a Strategy, Not a Law

Here’s what most doctors don’t realize:

“Standard fee for your area” is not a statute.
It’s not Medicare law.
It’s not carved into granite somewhere in a carrier’s headquarters.

It’s a negotiating position.

And every negotiating position can be challenged.

At Veritas Dental Resources, we don’t ask for favors. We present data.

Our 7-step process isn’t emotional.
It’s mathematical.

We analyze:

• Regional fee percentiles

• Carrier profitability

• Market saturation

• Production history

• Access-to-care leverage

• Network leasing layers

• Contract structure positioning

When you walk into a negotiation with data instead of hope, the conversation changes.

Carriers expect dentists to accept “standard.”

They don’t expect dentists to counter professionally and persistently.

The Real Question

If you don’t define your value… who will?

Because make no mistake, if you don’t present your case, the carrier will gladly define it for you.

And they will define it conservatively.

Your skill isn’t standard.
Your outcomes aren’t standard.
Your leadership isn’t standard.

So why would your compensation be?

Don’t Let “Standard” Become Your Ceiling

Benjamin, you’ve built a career helping over 10,000 offices stop playing defense with insurance companies. You’ve seen firsthand what happens when practices stop accepting default math and start presenting real numbers.

The shift isn’t just financial.

It’s psychological.

When fees reflect reality:

• Stress drops

• Production stabilizes

• Schedules breathe

• Teams feel less pressure

• Owners rediscover margin

Negotiation isn’t about greed.

It’s about alignment.

If your overhead reflects 2026, your reimbursements should too.

“Standard” is just the opening move.

What happens next depends on whether you respond.

And if you’re ready to stop letting convenience define your value…

It might be time to negotiate like a business owner, not like a participant.

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