Is your dental practice tired of arguing with insurance companies or waiting weeks (sometimes months) for reimbursement? If that sounds familiar, you might consider switching to the fee-for-service dental model.

Fee-for-service doesn’t mean your practice needs to abandon insurance. You can still accept insurance, but rather than waiting for reimbursement, you charge the full provider fee up front.

At Dental Intelligence, we help practices like yours increase dental production and learn how to attract more customers. Below, we explain more about the fee-for-service model and some perks and drawbacks you might want to consider.

The Fee-for-Service Model Explained

Fee-for-service practices are out-of-network dental clinics that charge patients the full provider fee up front. Because these practices don’t rely on reimbursement, they’re not beholden to providing only the services insurance companies will pay for. Patients can get the specific dental work they want rather than settling for what their insurance will cover.

Your practice can define its fee-for-service policy in one of two ways:

1. Tell patients the estimated amount due and request this amount at the time of service. Patients receive a statement if there’s any credit or amount due after insurance pays the estimated portion.

2. Have the patient pay the full fee at the time of service, then tell them to request reimbursement from their insurance provider. Of your two options, this is the quickest route to payment.

Fee-for-service may sound like a great model in theory, but it’s not right for all practices. Below, we discuss a few pros and cons of the model so you can decide whether it’ll work for you.

Pros of Fee-for-Service

Fee-for-service can be the right choice if your practice wants to get paid now. Here, we’ll talk about the model’s benefits.

A Higher Quality of Care

With fee-for-service, the emphasis is on quality over quantity. In-network practices can see dozens of patients a day simply because those practices accept their insurance. That can make running your practice feel like a chore, and it’s easy to get overwhelmed when you’re overbooked.

Because you won’t be in-network, fewer patients will find your practice through their insurance plans. That means you’ll have more time to spend with the patients you already have.

It’s Convenient for Patients

Digging through an insurance carrier’s network directory is a huge pain for many patients. Will insurance cover dental services at certain practices? What if the directory is outdated? When you switch to the fee-for-service model, patients no longer need to spend time hunting for a provider that takes their insurance. 

No Arguing with Insurance Companies

Have you ever argued with an insurance company that said your patient didn’t really need that crown or bridgework? This is all too common because insurance companies aren’t charities. Many will fight tooth and nail to avoid paying for care patients desperately need.

With fee-for-service, you’ll no longer spend hours on the phone haggling with insurance providers. That means patients get the care they need right away. Plus, you get paid immediately, which boosts your bottom line.

Cons of Fee-for-Service

Even though fee-for-service has plenty of perks, it also has some drawbacks.

Loss of Patient Referrals

Full fee-for-service practices (i.e., those that don’t accept insurance) no longer get patient referrals from insurance providers. Fewer patients can be good because it allows you to focus on those you already have, but it’s not so great for your bottom line. You may need to spend more on marketing to attract new patients.

Some Patients May Leave Your Practice

Not every patient will be pleased about having to pay their full bill up front. Expect some of your existing patients to bail, which, again, means you might have to shell out cash on advertising to attract new ones.

The Need for Patient Education

Insurance typically covers preventative care, such as cleanings and fluoride treatments. If you don’t take insurance, those services will no longer be covered, which may confuse patients. You’ll need to spend time explaining how your payment model works.

Does Fee-for-Service Make Sense for Your Practice?

Is fee-for-service right for your dental practice? Requiring upfront payments could be a good choice if you’re sick of dealing with insurance companies and want patients to get top-quality care.

And if you’d like to modernize the dental experience, try Dental Intelligence! We have years of industry expertise and know what it takes for practices to run smoothly. Request a demo of our software today.