Launching your own dental practice is exciting—and daunting. One of the biggest decisions you’ll make early on is this:

Should I join PPO insurance networks to attract new patients—or should I go fee-for-service (FFS) and stay fully out-of-network?

There’s no one-size-fits-all answer. Each model comes with trade-offs, and the best choice depends on your vision, risk tolerance, and growth strategy. Let’s break down the two paths and help you figure out what might work best for your startup journey.

Path 1: The PPO-Based Model

Joining PPOs (Preferred Provider Organizations) means signing contracts with insurance companies and agreeing to their pre-negotiated fee schedules. In exchange, your practice is listed as “in-network,” giving you potential access to thousands of patients looking for providers on their insurance plan.

Benefits:

• Faster patient flow: Being in-network often drives more new patients, especially in competitive markets.

• Lower barrier to entry: Patients are more likely to book when they see you’re “on their plan.”

• Potential for rapid early growth: PPO participation can help fill your schedule during those critical first 6–12 months.

Challenges:

• Deep discounts: PPOs typically reimburse 40–60% less than your full fees.

• High write-offs: The more you grow, the more money you potentially leave on the table.

• Administrative complexity: Multiple contracts, claims processing, and credentialing requirements can eat into your time and resources.

Important Tip: Before you sign a single PPO contract, negotiate your fees.
Many dentists don’t realize that insurance fees are negotiable—especially for startups with no prior fee schedule history.

Companies like Veritas Dental Resources specialize in PPO fee negotiations and credentialing, helping dentists:

• Secure higher reimbursements

• Avoid overlapping network contracts

• Reduce confusion and maximize profitability

Think of it this way: if you’re going to join PPOs, make sure you do it on your terms.

Path 2: The Fee-for-Service Model

A fee-for-service (FFS) model means you’re fully out-of-network with all insurance plans. Patients pay your full fee up front, and may submit claims to insurance themselves for reimbursement.

Benefits:

• Higher profitability: You keep your full fee—no write-offs.

• Greater autonomy: No insurance interference in your treatment decisions.

• Simplified operations: Fewer headaches with claims, networks, and credentialing.

Challenges:

• Slower patient acquisition: Patients may hesitate to see an out-of-network provider, especially without a strong referral or brand.

• Requires excellent marketing: You need a standout website, Google presence, online reviews, and social proof.

• Front desk training is critical: Your team must know how to guide patients through the value conversation—not just the cost conversation.

This model works beautifully in communities where:

• There’s a demand for exceptional care and experience

• Patients are less price-sensitive

• You’re willing to invest heavily in marketing and patient communication

What Does the Data Say?

There isn’t a single definitive dataset that proves PPO or FFS is always more successful. However, some trends are clear:

• PPO practices often grow faster in the beginning, especially if patient flow is the priority.

• FFS practices are often more profitable long-term, especially when marketing and branding are done well.

• Many thriving practices operate in a hybrid model, starting with PPO participation to gain traction, then gradually transitioning out of networks as their reputation and patient base grow.

Success depends not just on the model you choose, but how you execute it.

What Should You Consider Before Deciding?

Ask yourself:

• What’s my risk tolerance? (Am I comfortable growing slowly if I stay FFS?)

• How strong is my marketing plan?

• Do I have a unique selling point that sets me apart?

• Am I willing to negotiate PPO fees upfront if I join networks?

• What kind of patients do I want to attract—and how do they typically choose providers?

Best Practice: Choose With Strategy

Here’s a smart approach for startup dentists:

1. If you join PPOs, negotiate every fee before signing. Don’t leave tens of thousands on the table. Use Veritas Dental Resources to handle negotiations and credentialing so you get off to a strong start.

2. If you stay FFS, invest in marketing, branding, and front desk training. Patients will pay your full fee if they understand the value and experience you deliver.

3. If you’re unsure, consider a hybrid model—join select PPOs strategically (with good fee schedules), while building your reputation and marketing engine. Over time, you can drop low-fee plans and move toward a more profitable model.

Final Thought: The Model Doesn’t Make the Practice—You Do.

PPOs don’t guarantee success. FFS doesn’t guarantee failure (or vice versa). The success of your startup will come down to clarity, strategy, and execution.

So choose a model that fits your values. Be intentional with your contracts. And remember: your practice, your rules.

Need help negotiating your PPO fees or building a strong credentialing plan for your startup?
Visit www.veritasdentalresources.com to get expert support and protect your profitability from day one.

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