A friend once told me that having a great dental practice is all about how many patients walk through the front door, and that it has nothing to do with being in- or out-of-network with insurance plans. This was early in my journey as an out-of-network dentist. Now, I know that this advice is far from true! The key to running a successful dental office is maintaining profitability. Whether you are an in-network dentist, an out-of-network dentist, or a combination of both, understanding the business side of dentistry is essential.
This article will explore whether transitioning to an out-of-network model is the right move for your practice. If you are excelling in customer service and providing exceptional dental care, it’s time to evaluate your reimbursement rates to ensure that every plan you contract with is profitable. Regardless of your decision, every dentist should strive for continuous improvement to enhance their practice. By implementing the following strategies, you will attract more patients and create the opportunity to drop unprofitable insurance plans.
Strategies to attract new patients
A steady stream of new patients is crucial to your success. However, if you do not take the time to connect with them, fully diagnose their needs, and educate them about their treatment options, you may find yourself spinning your wheels. Acquiring new patients under an unprofitable plan can negatively impact your bottom line and increase overhead costs. In a busy in-network practice, the dentist and staff may not have enough time to properly educate patients about dental disease and treatment options, leading to lower case acceptance rates.
Building strong connections with both new and existing patients is especially important for practices considering an out-of-network model. If you or your team struggle to engage with patients in a meaningful way or fail to spend time getting to know them, they may not become loyal patients or refer others to your practice. Word-of-mouth referrals are the primary source of new patients for most practices and often surpass even Google searches. Ensuring that your patients feel valued and know you have their best interests at heart can significantly boost referrals. Simple reminders encouraging them to refer friends and family can also be effective.
Many dentists take pride in being booked out for months for new-patient visits. However, if patients have to wait longer than a week or two for an appointment, many will seek care elsewhere. Some in-network offices report being booked out six months or more—an indicator that it may be time to drop lower-paying insurance plans. Ask yourself: Are there barriers to scheduling? Do you offer online booking? Are your intake forms easy to complete? Put yourself in the shoes of a new patient and evaluate the entire experience—from the first phone call or online booking to the intake process. A seamless, efficient system improves patient satisfaction and retention. Technology can help streamline online booking and form submissions, making the process faster and more convenient.
In areas saturated with dental offices, leaving insurance networks may be more challenging but not impossible. If your office consistently receives word-of-mouth referrals and struggles to accommodate new patients, it may be a viable option. Researching whether other local practices accept certain plans or have long wait times for new patients can provide insight into your competition. Exceptional customer service is one of the greatest advantages of an out-of-network practice. Patients are often willing to pay more for a higher level of care and a better overall experience. However, retaining them requires consistently excellent service and genuine care from you and your staff.
Marketing is another crucial component of a successful dental practice. Word-of-mouth referrals remain the top source of new patients, but an updated, well-organized website with real photos of your office and staff can be just as important. After a Google search, potential patients will likely visit your website before deciding to book an appointment. Active social media engagement, positive online reviews, and targeted digital ads (such as Google ads and Meta ads) can also help attract more patients.
A clean and organized office environment plays a significant role in patient perception. While extravagant decor isn’t necessary, a tidy, well-maintained space reflects professionalism and attention to detail, helping to build trust. Clinical staff should wear uniforms and name tags, always presenting a professional appearance, and administrative staff should dress professionally and maintain a polished look.
Analyze your insurance plans
Once you have strengthened these core areas, it’s time to analyze the insurance plans you currently accept. Some plans reimburse at significantly lower rates, which may not be sustainable for your practice. While the acceptable threshold for insurance adjustments varies, generally, adjustments exceeding 30% can be detrimental to profitability, particularly in the hygiene department. Most dental software programs track insurance adjustments by plan, though some are more user-friendly than others. If you’re unsure how to access this data, consulting software support or searching for tutorials online can help. Understanding the true profitability of each plan will guide your decision on whether going out-of-network makes financial sense.
Leaving insurance networks is never an easy decision—it requires careful planning and time. Some offices may find that remaining in-network is the best option, and that’s completely fine. However, every practice can benefit from evaluating and improving key aspects of its operations. By doing so, you can strengthen your practice, enhance patient satisfaction, and achieve long-term success whether you stay in-network or make the transition.
Editor's note: The article appeared in the June 2025 print edition of Dental Economics magazine. Dentists in North America are eligible for a complimentary print subscription. Sign up here.
