Going Fee-for-Service? Here’s Who to Call First
There are a few professionals you can turn to for assistance when going fee-for-service. Here’s who to call, and when.
Marketing comes last, not first. A dental practice leaving insurance needs help in this order: (1) a dental-specific CPA to say whether it’s affordable, (2) a contract specialist to sequence which plans to drop, (3) a coach to fix phones, case presentation and team buy-in, (4) a membership-plan provider — and then (5) marketing. Fixing operations first and layering marketing on top is what makes the spend actually work.
We could deliver a hundred phone calls to a practice and it would not impact their new patient numbers at all if they’re not answering the phones well, or they’re not getting them on the schedule well, or they’re not selling treatment well. Fixing these operational areas first and then layering on marketing puts you in a significantly better position.
A dental practice leaving insurance needs several different kinds of help, and they’re not interchangeable. What follows is the whole map, in the order the work actually happens, with an honest account of where we sit on it.
1. A CPA who works only in dentistry
What they answer? Whether this is affordable, and on what timeline. Your true write-off across every plan. What happens to production and cash flow if a given percentage of patients leave. Where your fees sit against your market. Whether your overhead can absorb a transition year.
Why a dental specialist rather than your existing accountant? A generalist will do your taxes correctly and will not have a view on whether your lab bill is normal. The specialists carry benchmarks.
When? It’s your first step, before you have an opinion. This is the discipline that tells you whether the rest of the plan is real.
2. A specialist for insurance contracts
What they answer? Which plan to drop first, whether you can renegotiate rather than exit, what your notice obligations are, and which of your contracts you are in through an arrangement you have forgotten about. Practices are regularly surprised to find themselves in network through a plan they never signed with, because plans subcontract to one another.
When? Alongside the CPA you hire. The two conversations inform each other.
3. A dental coach
What they do? The phones, case presentation, the schedule, hygiene, and the leadership conversation with the team. In practical terms, whether your front desk can hold the line on a fee, whether treatment gets accepted, whether the day is structured for production rather than volume, and whether the people who work there understand why the practice is doing this.
Why does it matter more than marketing? Every one of those is a multiplier on every patient you already have. Marketing is a multiplier on attention, which is the cheaper input.
When? Before marketing, and well before the first plan comes off. Dental marketers are not coaches.
4. A membership plan provider
What they do? Design the plan, price it, and handle the billing and renewals, either an in-house annual plan or a managed monthly one, depending on how much administration you want to own.
Why do you need one? Briefly, the plan is what lets your team say no, but when a patient asks whether you take their insurance, and that sentence is worth more than the membership revenue.
When? This should be in place before the first plan comes off, not after.
5. Then, marketing
What they do? The website and the story it tells, reviews and reputation, social proof, visibility, and the tracking that follows a patient from the first click through to the chair.
When? Once the four above are handled, or at least honestly underway. A practice that has come to grips with the operational side of this is significantly easier to market, and gets considerably more for the same money.
What good looks like
The practices that come through a network exit well tend to have all five seats filled, in roughly that order. The CPA said it was affordable. The contracts came off in a sequence somebody had thought about. The team was trained before the phone got harder. The plan existed before it was needed. And then the marketing arrived, to tell people about a practice that was genuinely ready to receive them.
That version is not more expensive than the alternative. It is usually cheaper, because nothing gets bought twice and nothing gets bought early.
Where are you in the journey?
If you’re three months from dropping a plan and the only call you have made is to a marketing agency, you have started at the end. Call a dental CPA, then someone who reads the contracts, then a coach, then a plan provider. We will still be here, and by then we will be worth hiring.
If you want the names of the people we would call, ask us. It costs you nothing and it earns us nothing, which is rather the point. And, if it’s time for marketing, we’re here to chat.
Frequently asked questions
Who should a dentist call first when going fee-for-service?
A dental-specific CPA, before you even form an opinion. They tell you whether the transition is affordable and on what timeline. Your true write-off across plans, what happens to cash flow if a share of patients leave, and where your fees sit against your market. It’s the discipline that tells you whether the rest of the plan is real.
Why hire a dental CPA instead of my regular accountant?
A generalist will do your taxes correctly but won’t have a view on whether your lab bill is normal or your overhead can absorb a transition year. Dental specialists carry benchmarks for practices like yours, which is exactly what this decision needs.
Where does marketing fit in the sequence?
Last. Website, reputation, visibility, and tracking should come once the CPA, contract specialist, coach, and membership plan are handled or honestly underway. A practice that has come to grips with the operational side is far easier to market and gets considerably more for the same spend.
Do you charge for referring these specialists?
No. The introductions to dental CPAs, contract specialists, coaches, and plan providers cost you nothing and earn us nothing – which is rather the point. We’d rather you build the foundation first and be worth marketing to than take a retainer too early.