Transitioning to Fee-For-Service
Putting patients, not insurance companies at the center of care
If you’ve noticed that some dental offices are choosing to go out of network or transition to a fee-for-service (FFS) model, you might be wondering why — and what it means for you as a patient. While insurance-based dentistry has been the norm for decades, many practices are finding that a fee-for-service approach allows them to deliver better care, more transparency, and a more personalized patient experience.
Here’s a closer look at why dental offices make this transition and how it can actually benefit patients.
What Does “Fee-For-Service” Mean?
In a fee-for-service dental practice, treatment decisions are based on what’s best for the patient, not on what an insurance company agrees to cover. Patients pay the dental office directly, and the office can still help submit claims so patients receive any reimbursement their insurance plan allows.
This model removes the insurance company from the middle of the treatment decision process.
Why Dental Offices Move Away from Insurance Networks
1. Insurance limitations don’t equal quality care
Dental insurance plans often haven’t kept pace with modern dentistry. Many plans:
Cap annual benefits at low amounts
Cover only basic or outdated procedures
Deny or downgrade recommended treatments
By staying in-network, offices are often forced to compromise care to fit insurance rules rather than patient needs.
2. Rising costs without fair reimbursement
The cost of delivering high-quality dental care — advanced technology, materials, training, and skilled staff — continues to rise. Insurance reimbursements, however, often remain stagnant or decrease over time. This imbalance can limit the time and resources a dentist can dedicate to each patient.
3. Less administrative burden, more patient focus
Insurance-heavy practices require significant time spent on paperwork, claim disputes, and approvals. Moving to fee-for-service allows the dental team to spend that time where it matters most: caring for patients.
How Fee-For-Service Dentistry Benefits Patients
1. Treatment based on health, not coverage
In a fee-for-service model, your dentist recommends care based solely on:
Long-term oral health
Function and comfort
Aesthetics and prevention
You won’t hear, “Your insurance won’t allow that,” when a better option exists.
2. More time with your dentist
FFS practices typically schedule fewer patients per day, allowing:
Longer appointments
More thorough exams
Clearer explanations of treatment options
This leads to stronger relationships and better understanding of your oral health.
3. Higher-quality materials and modern technology
Without insurance restrictions, practices can invest in:
Advanced diagnostic tools
Better restorative materials
Modern techniques that improve comfort and outcomes
These choices often result in longer-lasting dental work.
4. Transparent pricing
Fee-for-service practices provide clear, upfront pricing so patients know exactly what to expect. There are no surprise downgrades or denied claims dictating last-minute changes to care.
5. Insurance still works for you
Being out of network doesn’t mean you lose your insurance benefits. Many offices still:
Submit claims on your behalf
Help maximize out-of-network reimbursements
Explain benefits clearly so you can make informed decisions
A Shift Toward Patient-Centered Dentistry
Transitioning to fee-for-service isn’t about making dentistry more expensive — it’s about making it more honest, more personalized, and more focused on long-term health. For many patients, the value of unrushed appointments, high-quality care, and treatment decisions based on health rather than insurance rules far outweighs the difference.
At its core, fee-for-service dentistry puts patients — not insurance companies — back in the driver’s seat.
Here are 2 references from the ADA that discuss some of these trends in the dental insurance market:
https://adanews.ada.org/ada-news/2024/may/3-dental-benefit-trends-you-should-know/
https://adanews.ada.org/ada-news/2025/november/dear-ada-out-of-network-providers/
Lastly, remember these 2 concepts: Delta Dental of Virginia is one of the most profitable ‘non-profits’ in the state of Virginia. Insurance companies are in the business of making money.