33% of Practices Might Drop Insurance Networks: How to Adapt

Practices are reconsidering their relationship with their  insurance networks.

Because for providers, navigating insurance headaches is a full-time job. In fact, it’s often several full-time jobs for some practices.

And as these headaches become paired with diminishing reimbursement rates and increased patient dissatisfaction, practices are starting to look for alternative solutions.

Because let’s face it: the dental industry is experiencing a seismic shift as practices nationwide are looking for alternative approaches to maintain practice financial health.

A Q2 2025 ADA economic outlook survey revealed that 23% of dentists dropped some or even all of their insurance networks in 2024, with 33% seriously considering it for 2025. This is averaged across all practice types, sizes, and geographies. This trend is driven primarily by:

• Low reimbursement rates 
• Increasing administrative burdens

It is fundamentally changing how dental practices operate. It’s also changing business models for some. While this shift certainly doesn't mean that all practices are looking to fully embrace a fee-for-service approach, we do see elements of it emerging as practices take a good look at their options.

Let’s talk about what some of these monumental changes will look like for practice operations.

What will happen with the front office?

For front desk staff, dropping insurance networks creates an entirely new job description. What once involved routine insurance verification and co-pay collection might soon require complex patient education and financial counseling skills.

Much of the administrative workflow will be transforming. Instead of insurance-focused scheduling that prioritizes covered procedures, staff will manage cash-based appointments and payment plan logistics. This paradigm shift requires new training on fee-for-service billing and often means implementing entirely new payment processing systems.

The transition from fielding calls about claims to having detailed financial conversations with every patient will require a re-evaluation of how staff is trained and who is ultimately hired in this new environment.

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How will treatment coordinators adapt?

Next comes issues around case acceptance.

For dental hygienists and assistants, leaving insurance networks often means longer appointments as financial discussions become part of routine care. Treatment presentations need to be dialed in and include a discussion about payment plan financing.

Patients will need to understand why comprehensive care, while more expensive upfront, provides better long-term outcomes.

These treatment planning conversations evolve significantly. Without insurance dictating covered procedures, financial expectations are largely out the window. 

After this transition, doctors can recommend optimal treatments without insurance considerations; however, they must also help patients understand the investment required. This shift often leads to more thorough treatment plans (and better oral health outcomes) but requires enhanced communication skills from the entire clinical team.

What are the new financial coordination challenges?

The revenue cycle undergoes dramatic changes when a practice leaves its insurance network. Coordinators must pivot from tracking insurance reimbursements to managing direct patient collections, often while processing out-of-network claims for patients who choose to seek reimbursement independently.

And counterintuitively, cash flow management becomes more complex during the transition period. Practices experience initial revenue volatility as they lose some patients while building a new direct-pay patient base. This requires careful financial planning and often temporary adjustments to staffing or operational expenses.

The shift also demands new collection procedures and investment into the tools to automate that collections process. Rather than pursuing insurance companies for unpaid claims, staff changes focus to patient payment plans and direct collection strategies. This change often improves cash flow timing but requires different skills and systems.

Of course, practices have processes in place that address these cases as one-offs or a small percentage of their accounts receivable (A/R), but a full transition to exclusively patient-portion collection requires more adaptation from staff and from patients.

What will happen to the patient experience?

Let’s put the staff challenges aside for a moment and focus on the patient base. Patients face the most dramatic operational changes. Routine dental visits transform from predictable co-pay experiences to significant financial decisions.

This financial shift forces patients to budget differently for dental care. Instead of planning for routine co-pays, families must consider dental care as a major household expense, often leading to delayed treatments or payment plan requests.

Access to care becomes more challenging for some patients. As practices leave networks, patients must choose between following their preferred dentist (and paying more) or finding new in-network providers. This choice often disrupts established relationships and ongoing treatment plans.

The decision-making process around dental care fundamentally changes. Patients begin weighing cost versus clinical necessity more carefully, sometimes prioritizing immediate needs over preventive care that could save money long-term.

How new software and new training approaches are paving the way

Without consistent insurance reimbursements and more complex patient payment dynamics, practices will need to invest in new strategies and tools for maintaining healthy cash flow:

SOFTWARE INTEGRATION IS #1

Successful practices implement comprehensive technology upgrades to manage the transition. Dedicated billing workflow systems, patient portals with transparent pricing, and in-house membership software designed to be the face of your brand become essential tools.

The tools your practice chooses to integrate will work to help your staff and your patients navigate the turbulence that accompanies insurance network disuse.

STAFF RE-TRAINING MUST FOLLOW

Staff training becomes crucial for success. Team members need skills in financial communication, conflict resolution, and value-based selling. Many practices develop standardized scripts for discussing treatment costs and payment options, ensuring consistent messaging across all patient interactions. This is especially important to dial in for multi-location groups and DSOs.

Patient retention strategies focus on demonstrating value through personalized attention, shorter wait times, and comprehensive care approaches. As mentioned, some practices implement membership plans or subscription models to provide predictable costs for routine care.

The long-term benefits of dropping insurance networks

Let’s say that the contract with your insurance network has just expired, and you’re facing the choice of renewal.

Unless you’re satisfied with the reimbursement rates and your claims process is hassle free, it might be time to consider alternative models.

Practices that successfully navigate the transition often discover:

• Complete control of fees and specialized procedure offerings
• Overall improved patient health outcomes
• Reduced administrative burden
• Higher profitability through fee-for-service offerings combined with membership programs

The competitive landscape shifts as practices differentiate themselves through service quality rather than insurance acceptance. This change often leads to specialized service offerings and premium care positioning.

Many practices report improved job satisfaction among staff who no longer spend time battling insurance companies over coverage decisions. This change, while initially challenging, often results in more meaningful patient relationships and clinical autonomy.

How to safely transition to out-of-network: Strategic Implementation

For practices considering this transition, a phased approach proves most effective. Starting with one insurance network while maintaining others allows gradual adaptation and reduces financial risk. During this period, your practice can develop its new systems for training staff, and build their direct-pay patient base.

Success metrics shift from insurance reimbursement tracking to patient retention rates, average treatment values, and direct collection percentages. Practices must also monitor patient satisfaction scores carefully during the transition period.

The Path Forward

The trend toward insurance independence represents a fundamental shift in the ways practices think about their financial and administrative operations. While challenging initially, practices that successfully manage the transition can see improved profitability and better oral health outcomes for patients.

The transition period doesn’t have to be rocky.

The key to success lies in thorough preparation. Staff need comprehensive re-training, patient expectations need to be re-established, and the right tools need to be invested in.

As this trend continues, practices that adapt their operations effectively will likely find themselves better positioned for long-term success in an evolving healthcare landscape.

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