Dentistry has always been about patient care, but today’s dental professionals are increasingly rediscovering the power of going out of network with dental insurance. For many dentists, this shift is less about risk and more about reclaiming control, profitability, and peace of mind.

If you've ever felt overworked, undervalued, or burned out despite a full schedule, this article is for you.

The Financial Reality of Staying In-Network

PPO participation often feels like a necessity — but it comes with a hidden price. The average write-off for PPO plans is between 30–50% of a dentist’s standard fee schedule. (Source: ADA Health Policy Institute, Practice Booster – Dr. Charles Blair)

Let’s break that down:

• A crown with a UCR fee of $1,400 may be reimbursed at only $850 under a PPO plan.

• You do the same clinical work, but give up $550 per procedure — every time.

• Multiply that across dozens of procedures a week, and you're leaving tens of thousands on the table monthly.

A solo dentist producing $1 million/year with 40% write-offs is losing $400,000 annually — not due to lack of patients, but due to contractual discounts.

How Profitability Improves Out-of-Network

Dentists who go out of network often report:

• Fewer patients, but higher revenue per visit

• Better case acceptance when time is spent educating rather than rushing

• A shift from quantity-based to quality-based care

According to a 2021 study by The Profitable Dentist, practices that drop PPOs and implement smart out-of-network strategies increase net income by 20–30% within the first year — even with modest patient attrition.

What About Patient Loss? Less Than You Think

Many doctors fear losing a majority of their patient base when going out of network — but the reality is far more encouraging.

Research from Dental Success Institute and Dental Intelligence shows that 60–80% of patients will stay with their dentist after leaving insurance networks — especially if:

• The office explains the change clearly

• Help is provided with claims submission

• A strong relationship already exists

Patients value trust, quality, and experience — and are often more loyal to their dentist than to their insurance plan.

More Than Just Money: Fulfillment and Work-Life Balance

Going out of network isn’t just a business decision — it’s a lifestyle upgrade.

Dentists consistently report:

• Less stress and burnout

• More time with each patient

• Freedom to choose the labs, materials, and techniques without insurance restrictions

• A renewed sense of professional pride and autonomy

In a survey by Dental Economics, dentists who transitioned out of network said they experienced:

• Greater fulfillment (76%)

• Improved work-life balance (68%)

• Increased team morale (55%)

How to Transition Successfully

Going out of network doesn’t mean dropping all plans overnight. Successful transitions often follow this path:

1. Analyze your payer mix – Identify the least profitable plans.

2. Start small – Drop one plan at a time and monitor retention.

3. Educate your team – They’re your front line for patient conversations.

4. Offer membership plans – Many patients prefer these over insurance anyway.

5. Communicate proactively with patients – Clarity, confidence, and empathy go a long way.

Final Word: Own Your Practice, Don’t Let Insurance Own You

The decision to go out of network is not about abandoning patients — it’s about redefining the way you care for them and for yourself.

By eliminating restrictive contracts, you free yourself to:

• Charge what you're worth

• Spend more time on quality care

• Build a team-centered, patient-focused, sustainable practice

If your schedule is full, your patients love you, and you're delivering great care — you have the leverage to create a more profitable, fulfilling practice model.

Would you like help customizing a patient communication letter, or building a roadmap to start transitioning off PPOs? I’d be happy to assist.

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