Why Dentists Are Ditching PPOs—and Not Looking Back

Why Dentists Are Ditching PPOs—and Not Looking Back

April 17, 20254 min read

There’s a quiet revolution happening in dentistry. Maybe not so quiet, actually.

Doctors everywhere are drawing a line in the sand and declaring, “No more.” No more downgraded composites, no more begging for reimbursements, no more plans telling them how to do their jobs.

They’re going out of network—and they’re not looking back.


Out of Network Isn’t a Protest. It’s a Return to Purpose.

For years, dentists have been sold a lie: that participation in dental insurance networks is the only way to grow. That staying in-network is synonymous with patient loyalty. That low reimbursements are just the cost of doing business.

But here’s the truth:

The dental insurance system wasn’t built for you. And it definitely wasn’t built for your patients. It was built to make investors rich.

I'm an investor, does that make me evil? No! Why, because I'm guessing that you are an investor too where your funds manager invests in profitable business models like insurance. It's a system that works for others, but unfortunately, not for your practice.

If you're feeling like the hamster in a wheel of PPO paperwork, insurance denials, and coding games—you’re not crazy. You're simply operating in a system designed to distract you from your purpose: taking care of patients.


Going Out of Network Isn’t Radical. It’s Responsible.

When a dentist chooses to leave an insurance network, it’s not an act of rebellion—it’s an act of preservation.

Preservation of:

  • Clinical integrity

  • Financial sustainability

  • Sanity

  • Authentic patient care

As detailed in the [Veritas Out-of-Network Best Practices Guide] (which might be the best thing you’ve never read), the most successful transitions come from clarity, communication, and conviction.

Here’s the secret sauce: give patients advance notice, explain that the change is to remove restrictions that block quality care, and emphasize that they’ll still have access to their benefits. Most patients will nod in agreement. A few will grumble. Some might leave. But those who stay? They’re with you for the right reasons. Don't worry about the problem patients that consistently give you nightmares. Let them leave and be someone else's problem. 


Insurance Is the Distraction. Patients Are the Mission.

Let’s not mince words. Insurance has done a bang-up job at distracting dentists from their mission.

You didn’t go to dental school to decode CDT codes or fight with pre-authorizations. You didn’t take on student loans to become an underpaid middleman between patients and corporations.

You went into dentistry to help people—to heal, restore, and guide patients to health.

Every time insurance tells you to downgrade a composite, deny a crown, or limit treatment to what’s "covered," it’s not just a coding issue—it’s a clinical interference.

Going out of network is your way of reclaiming autonomy, of saying “Enough!” to a system that was never meant to serve you.


But What About the Patients?

Here’s the irony: most patients don’t care nearly as much as we think they do.

When communicated properly, patients:

  • Understand that “out of network” doesn’t mean “no benefits.”

  • Respect that you're choosing quality over quantity.

  • Appreciate being included in the decision ahead of time.

Using Veritas Dental Resources’ scripting, the message becomes clear:

"We’re becoming an unrestricted provider (which is out of network) because we believe you deserve the best care possible—care that isn’t dictated by insurance rules designed to save them money, not make you healthier."

That’s the story. That’s the truth. That’s what patients want to hear.


The Doctors Who Leave? They Don’t Look Back.

Doctors who’ve transitioned out of network consistently report: Higher job satisfaction
More time with patients
Better treatment acceptance
Stronger patient relationships
Improved financial outcomes

Why? Because they’re no longer playing by rules designed to keep them small. They’ve made space for their values, team, and patients to come first.

And they’ve stopped apologizing for it.


Your Next Step: Education + Strategy

If you’re considering making the leap (or even just curious), don’t go it alone. Veritas Dental Resources has developed a comprehensive framework for transitioning successfully—including phone scripting, in-office talking points, patient letters, and strategy consulting.

Also, if you’re still battling the nuances of coding and billing, grab a copy of Coding with Confidence by Dr. Charles Blair and visit the Veritas Dental Resources Blog—your one-stop shop for insurance training, updates, and sanity-saving insights.


Final Thought: Don’t Wait for the System to Change

The system wasn’t built for dentists. But your practice? Your team? Your patients?

They were.

Go where your passion is. Stand by your training. Deliver the care you were meant to.

Go out of network—not in anger, but in clarity. Not as a protest, but as a promise.

To your patients.

And to yourself.

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

Benjamin Tuinei is a leading expert in PPO strategies and fee negotiations, recognized by multiple state dental associations and continuing education institutions. Since beginning his dental career in 2007, he has helped over 9,000 dentists improve insurance reimbursements, influencing more than $5 billion in negotiated revenue. His expertise in restructuring billing departments increased collections from 65% to 98%, and his negotiation skills with third-party payors boosted insurance revenue by nearly $1 million, earning widespread recognition from dental practices across several states.

Benjamin Tuinei

Benjamin Tuinei is a leading expert in PPO strategies and fee negotiations, recognized by multiple state dental associations and continuing education institutions. Since beginning his dental career in 2007, he has helped over 9,000 dentists improve insurance reimbursements, influencing more than $5 billion in negotiated revenue. His expertise in restructuring billing departments increased collections from 65% to 98%, and his negotiation skills with third-party payors boosted insurance revenue by nearly $1 million, earning widespread recognition from dental practices across several states.

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