How to Raise Fees When Going Fee for Service: The Ultimate Guide to Reclaiming Your Practice Sovereignty
In most practices we see, the dentist is working like a rented mule, running from op to op, only to realize at the end of the month that the “Evil Empire” (insurance companies) took a 40% haircut off the top. It’s a non-functional model that is eventually going to collapse on itself.
Typically, a dentist wants to earn more per patient but feels held hostage by a PPO contract. You want to provide world-class clinical care, but your reimbursement rates haven’t changed since the turn of the millennium. It’s a recipe for burnout and mediocre profitability.
Are you tired of being the middleman for Delta Dental? Does your day sheet show massive write-offs that make you want to weep into your morning coffee? In our experience, the only way out of this trap is to learn how to raise fees when going fee for service and replace those discounted plans with a predictable, high-margin membership program. This shift is key to improving your case acceptance rate.
In this article, we’re going to get granular. We’ll show you exactly how to flip the switch, raise your fees, and keep your patients loyal to your chair—not their insurance card. 🚀
The Real Problem Isn’t Your Fees—It’s Your Lack of a Parachute
A common mistake is thinking that patients choose you because of your PPO status. If that’s true, you don’t have a practice; you have a distribution center for an insurance company. The real problem isn’t that your fees are too high; it’s that you haven’t built a “lateral move” for your patients to exit the insurance trap. This can lead to significant patient retention problems if not addressed.
When you drop a PPO, the insurance company will send a threatening, misleading letter to your patients. It won’t say they *can’t* see you; it will just imply that it would be a financial disaster if they did. If you don’t have a membership plan in place, that letter wins. You need a parachute.
That parachute is BoomCloud™. By creating your own in-house dental membership plan, you give patients a logical reason to stay. You aren’t just raising fees; you are offering a better value proposition that solves the patient’s need for “coverage” without the corporate red tape.
How Can I Make My Dental Practice Grow by Going FFS?
In the Automatic Patient Podcast, we often discuss the “Fee-for-Service Jump.” It’s terrifying, but it’s the most liberating thing you’ll ever do. To make your practice grow, you have to prioritize revenue per patient over volume. 📈 This is a core component of successful DSO growth.
When you are in-network, you are forced to see 30+ patients a day just to keep the lights on. When you go FFS, you can see fewer people, do better dentistry, and actually spend time building relationships. Membership patients are the holy grail here—they spend 2X to 4X more on elective treatment than insurance patients because they aren’t limited by an arbitrary $1,500 annual cap.
- 🔥 Stop chasing the “hygiene-only” patient who leaves the moment their insurance expires.
- 🔥 Start attracting the “identity” patient who sees you as their trusted healthcare advisor.
- 🔥 Focus on MRR (Monthly Recurring Revenue) to stabilize your cash flow.
The Financial Impact: Why Most Practices Fail at Solving This
Most dental practices fail at this because they try to “pull the Band-Aid off” without strategy. They just drop the PPO and hope for the best. That’s not a plan; that’s a suicide mission. You need to understand your dental practice KPIs and the math behind the transition. Understanding your dental practice statistics is crucial here.
Let’s look at the financial impact of raising fees and shifting to a FFS model supported by BoomCloud™.
Case Study: Sun Valley Dental Transition
| Metric | Before (PPO Dependent) | After (Membership Focused) |
|---|---|---|
| Member Count | 0 | 850 |
| Write-Offs | 42% Avg | 0% (Fee for Service) |
| MRR (Monthly Recurring Revenue) | $0 | $29,750 |
| ARR (Annual Recurring Revenue) | $0 | $357,000 |
| Patient Treatment Acceptance | 31% | 58% |
Operator Insight: This practice achieved these numbers in just 14 months. The “secret” wasn’t just dropping Delta; it was moving the patients laterally into their own plan. They traded a 40% discount for a 15% membership benefit. The math is simple: they kept 25% more of their production immediately. 💰
The Step-by-Step Blueprint on How to Raise Fees When Going Fee for Service
If you’re serious about this, you can’t just wing it. You need a methodical approach to increase your fees while transitioning out of the PPO chokehold. This includes optimizing your dental appointment scheduling software for a FFS model.
1. Analyze Your UCR Fees
Most dentists have their UCR (Usual, Customary, and Reasonable) fees set too low. Before you drop a PPO, raise your UCR to the 80th or 90th percentile for your zip code. Use tools like NDAS to get accurate data. You need to be profitable on every procedure before you even think about discounts.
2. Arm Your Team with Verbiage
In most practices we see, the front desk is the “Department of Denial.” They are afraid of the money conversation. You must train them on how to talk about the transition. Instead of saying, “We don’t take your insurance anymore,” they should say, “We’ve decided to prioritize our patients’ care over the restrictions of insurance companies. We now have a private membership program that offers more coverage for less than your typical premiums.” Effective communication is crucial to prevent cancellations in the dental office.
3. Optimize Revenue Per Patient
If you want to know how to run a dental office efficiently, you have to look at dental practice KPIs like Production Per Visit. Membership patients are easier to close on treatment because they feel like they are “insiders.” They get a 10%–15% discount on larger cases, which removes the friction of “What will my insurance cover?”
The “Ice Cream Box” Trap: Why One Size Doesn’t Fit All
In our experience, dentists think they need one plan for everyone. Wrong. You should have tiers: Child, Adult, and Periodontal. This ensures you are being reimbursed fairly for the actual clinical time spent in the chair. A Perio patient requires more resources—your plan should reflect that. If you treat everyone the same, you are losing money on your highest-risk patients.
Operator Insight: What Actually Works (Insider Knowledge)
From experience, the practices that win at FFS utilize these three secrets:
- 🌟 The “Who, Not How” Principle: Don’t try to build the software yourself or use a spreadsheet. Use BoomCloud™ to automate the billing. If your team has to manually charge credit cards, they will quit.
- 🌟 The Bonus Incentive: Bonus your team for every new member they sign up. It gets them excited to have the “insurance talk” rather than avoiding it.
- 🌟 Frequency of Communication: Send emails and texts explaining your new FFS status months *before* you drop the contract. Educate, don’t just announce. We even offer guaranteed new patient marketing strategies to support your growth during this transition.
Financial Breakdown: Simple Math for the Skeptic
Let’s say you produce $1.2M a year. If you are in-network with a heavy PPO base, your write-offs are likely $400k+. You are netting $800k before overhead. If your overhead is 65% ($520k), your take-home is $280k.
Now, if you go FFS, your production might dip slightly as some “insurance-only” patients leave. Let’s say production drops to $1M. But now, your write-offs are $0. Your overhead remains $520k. Your take-home is now $480k. You worked 20% less and made $200k more. That is the power of sovereignty. 🦅
FAQs: Navigating the Transition
H3: How can I make my dental practice grow if I lose 20% of my patients?
Typically, when you go FFS, you may lose the bottom 15%–20% of your patient base—the “coupon shoppers.” This is actually a blessing. It frees up your schedule for high-value membership patients who accept treatment at 2X the rate of PPO patients. Higher revenue per patient easily offsets the loss in volume. Practices can even use dental advertising samples to attract this new patient demographic.
H3: What are the most important dental practice KPIs when raising fees?
You should track your **Case Acceptance Rate**, **Annual Recurring Revenue (ARR)** from your membership plan, and **Net Production per Hour**. If these are trending up, your FFS transition is successful. Don’t obsess over “New Patient Count” if they are all low-value PPO patients. You might even find funnier approaches to marketing, like funny dental ads, to gain attention without sacrificing value.
H3: How to run a dental office without insurance headaches?
The best way is to implement an automated membership system like BoomCloud™. This turns your practice into a subscription-based business model. Instead of waiting 60 days for a $400 check from a PPO, you get your MRR deposited every month like clockwork. This stability allows you to manage your office with peace of mind and focus on effective internet dental marketing.
Stop Being a Victim to the PPO Trap
You didn’t go to dental school for four years, take on $400k in student debt, and spend decades honing your craft just to let a cubicle jockey at Delta Dental tell you what a crown is worth. Raising your fees and going FFS isn’t just a business move—it’s a self-respect move.
Software alone doesn’t solve this. You need a strategy, a team that rows together, and the guts to believe you are worth the fees you charge. BoomCloud™ provides the infrastructure, but you provide the vision. It’s time to stop working for the insurance company and start working for your patients and your family.
Ready to see the math for your own office? Calculate your opportunity today and let’s get you out of the PPO trap once and for all.
Schedule a Demo & Calculate Your Opportunity
Additional Resources:
