How to Create a Membership Plan in a Fee for Service Practice
Are you tired of working like a rented mule for insurance companies that haven’t raised their reimbursement rates since 1998? In most practices we see, the owner is literally suffocating under a mountain of PPO write-offs. Typically, a dentist will produce $1.2M, but after the “insurance haircut,” they only see $800k. That’s $400,000 of your hard-earned labor vanishing into the pockets of billionaires in suits. If you want to protect your practice and reclaim your clinical freedom, you must learn how to create a membership plan in a fee for service practice. It is the only way to build an “Insurance-Proof” wall around your patients.
The PPO Trap: Why Your “High Volume” is Killing You
In our experience, dentists are addicted to the “drug” of new patient flow from insurance lists. But here is the epiphany I had after managing a dental lab: PPO patients aren’t loyal to you; they are loyal to their employer’s benefits package. As soon as that employer switches to a plan you don’t take, that “loyal” patient is gone. They disappear faster than a sugar cube in hot coffee. The real problem isn’t that you don’t have enough patients; it is that you don’t own the relationship.
When you implement dental appointment scheduling software with marketing tools, you reclaim your power. You transition from being a victim of the “evil empire” to a Fee For Service (FFS) powerhouse that actually gets paid what it’s worth. Transitioning away from insurance relies on a solid internal structure.
How to Create a Membership Plan in a Fee for Service Practice and Increase Revenue
An insurance patient only does what the “plan covers.” If the insurance says no to a crown, the patient says no to you. On the other hand, a membership patient has a different mindset. They aren’t looking at “coverage”; they are looking at their dental loyalty program as a commitment to their health. In our experience, membership patients spend 2X to 4X more on elective and restorative treatment than insurance patients. You’ve removed the financial friction and given them a reason to say “yes.”
The Math of Freedom: MRR vs. Empty Chairs
What happens if you have a slow week? If the chairs are empty, your revenue is zero. But with a membership plan managed by dental membership software, your revenue never stops. Imagine waking up on the 1st of the month with $30,000 already in your bank account before you even pick up a handpiece. This covers your base overhead—rent, payroll, supplies—leaving your production for pure profit.
How to Set Up a Dental Membership Plan (The “No-Brainer” Setup)
If you want to know how to create a membership plan in a fee for service practice effectively, stop overcomplicating the pricing. I’ve seen practices try to offer 15 different tiers. Don’t do that. You’ll confuse your team and your patients.
Keep your plan structure simple:
- Adult Plan: Covers hygiene, exams, x-rays, and a 15% discount on everything else.
- Child Plan: Includes fluoride treatments and extra cleanings.
- Perio Plan: Specifically designed to cover 3-4 cleanings per year.
The goal isn’t to be “cheap.” The goal is to be accessible. By using software to scale a dental membership plan, your team doesn’t have to act like a collection agency. The software handles the rebilling, the expired credit cards, and the automated emails.
Case Study: Transitioning to a Fee For Service Model
A common mistake is thinking you can just drop Delta Dental cold turkey and hope for the best. A plan without a strategy is risky. In most practices we see, a gradual approach works best where you replace poor-paying PPOs with membership members. Take a look at this real-world impact for a practice that moved toward a Fee For Service model:
| Metric | Before BoomCloud™ | After 12 Months | After 24 Months |
|---|---|---|---|
| Member Count | 0 | 450 | 825 |
| Monthly MRR | $0 | $15,750 | $28,875 |
| Annual ARR | $0 | $189,000 | $346,500 |
As Dr. Dan Nelson noted on the Automatic Patient Podcast, “Nobody regrets going out of network, but everyone regrets not having a plan before they do it.”
Why Most Practices Fail at Solving the Insurance Problem
Software alone doesn’t solve this. If you buy a platform and just let it sit there, nothing will change. The real reasons practices fail include:
- The Team Isn’t “All In”: If your front desk thinks the plan is “extra work,” they will bury it. Incentivize them!
- Weak Verbiage: You need proper scripts. Don’t just ask if they want to “join a plan.”
- Pricing Paralysis: Don’t spend six months debating a few dollars. Pick a price and start.
- Lack of Outreach: You need marketing tools to reach the “uninsured” in your town.
The Financial Impact of Future-Proofing Your Practice
Let’s do some quick math. If you have 500 members paying an average of $35/month, that is $17,500/month in MRR. That equals $210,000/year in ARR. Because membership patients have higher case acceptance rates, the total value of your patient base effectively doubles. This is the ultimate goal when researching how to create a membership plan in a fee for service practice.
The “evil empire” of insurance companies is getting smarter, using AI to deny claims and buying up practices to compete with you as discussed here. You have two choices: continue to be a victim of shrinking reimbursements, or build your own “Private Health Network.”
Resources to Help You Scale:
- Download the million-dollar membership plan ebook
- Take The Six-Figure Patient Membership Plan Course
- Schedule a Demo of BoomCloud™
