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Fee for Service Dentistry is Full of Problems

by Sep 28, 2022Pricing

Fee for Service Dentistry is Full of Problems

by | Sep 28, 2022 | Pricing

Too many fee for service dental practices operate like an auto mechanic. 

That doesn’t mean they’ll change your engine oil instead of cleaning your teeth…although if there’s a small town where the local dentist-mechanic offers both those services, we’d like to see it. It means that, like an auto mechanic, many dentists hand their patients a long bill of the services they performed after the work is done. 

Straightforward enough, right? 

But if you think about the last time you had your car worked on, did you only pay for things you expected to when the work began? Or rather, did your bill for parts and labor also come with a dozen smaller fees for materials, replacement fluids, inspections, regulations, and the like?

Even if your mechanic was good and honest, if you’re like us, you did a double take. 

Dental practices that run on a Fee-for-Service model handle billing in much the same way. The cost of a crown or a filling comes with a dozen other fees, from supplies and materials to things like X-rays, inspections, tests ordered or prescriptions given. Like a mechanic’s bill, everything is listed separately in one rambling, confusing invoice…and unless they’re in dental school, any patient trying to read it might as well be reading Sanskrit.  

But as it turns out, confusion and frustration with billing aren’t the only drawbacks to the Fee-for-service model. 

From insurance reimbursements that don’t cover everything on the bill to incentivizing dentists to pack more patients in and rush them through unnecessary tests and procedures, there’s a ton of reasons why more and more people are leaving fee-for-service dentistry… and trying membership-based Direct Dental Care.

Here’s a few of them. 

Fee for Service Lacks Accountability

Using the fee-for-service model, hospitals find creative ways to bill patients insane amounts… without letting them know about it. 

One example: a college student in Colorado who went to the emergency room for a ruptured ovarian cyst was charged $700 every time a nurse gave her medicine through an IV. 

Her grand total? 


While advocates of fee-for-service might use eye-popping incidents like this as an argument for traditional insurance, that’s precisely where it gets tricky. Like medical insurance, traditional dental insurance doesn’t always cover everything on the bill. 

With costs, regulations, insurance coverage limits, and dental technology all changing rapidly, practices stuck with the fee-for-service model risk charging patients for items that may not be covered. 

Intentional or not, a model that obscures treatment costs and leaves patients wondering whether or not everything on the long invoice will be covered is one that lacks accountability. 

Fee for Service Discourages Preventative Care 



Routine check-ups with a dentist you know and trust. 

We all know that optimal oral health is best achieved with minimal, preventative, long-term care. 

Unfortunately, the fee-for-service model discourages that. 

Instead, dentists paid for services they perform often find their calendars squeezed with too many patients. As far as costs and incentives go, many find their practice tilting toward invasive (yet profitable) dental procedures, along with tests and treatments that patients may not even need. 

The incentives, along with the rising costs for everyone involved, are such a huge problem that even dental insurance companies recognize it. But while many companies try to lower costs by bundling procedures together, the overall structure of paying dentists for services they perform remains in place. 

Meanwhile, third party control over dental services and their respective fees grows even more complicated, arbitrary, and costly. In the end, the system pressures dentists to cram more patients in, and go right for drastic procedures where they should emphasize long-term prevention. 

The biggest loser? 

Patients and their teeth. 

Fee for Service Gets in the Way 

People didn’t always hate going to the dentist. 

But in the fee-for-service model, with third party insurance reimbursing those fees, the patient-dentist relationship grew a lot more complicated… and that mental image of the dentist as a mad scientist with a huge, whirring drill grew a lot scarier. 

We’re taking some artistic license here. 

But even so, it’s a sad, widespread truth that many patients don’t have a close, trusting relationship with their dentist—the one person who can guide them toward best practices for a lifetime of oral health. 

Why don’t they? 

Along with third party insurance interfering more and more, the fee-for-service emphasis on volume and productivity minimizes the relationship. Where insurance companies, and health care providers like Medicare and Medicaid grow overburdened with fee-for-service costs, limits and restrictions get passed down to the patient. 

That can even mean roadblocks for personal visits, routine tests, follow-ups, and the like. On the dentist’s end, the calendar is usually crammed full. 

Is it any wonder that patients who are overcharged, deprived of preventative care, and not given enough facetime don’t know or trust their dentist? 

Go figure. 

Direct Dental Care 

What’s the alternative to fee-for-service dental care? 

Turns out, it’s something that’s appropriately called Direct Dental Care.

Instead of a long, itemized list of services provided and what they cost, dental patients reap all the benefits of complete, preventative care for a flat, monthly membership fee. With predictable costs, the direct dental care model offers a full spectrum of dental treatment, and without the lack of communication and facetime that strains dentist-patient relationships. 

In many cases, direct dental care offers elective and cosmetic services for a straightforward, reduced fee, offering price transparency and accountability. 

Most importantly, dentists and patients are incentivized to take the superior, preventative approach together. Rather than working to fill out long invoices with unnecessary services, dentists are free to focus on prevention, holistic treatment, and patient satisfaction. 

Better than traditional insurance, and free from the hang-ups of fee-for-service, direct dental care unlocks the service, care, and satisfaction that patients increasingly prefer. 

A Better Way is Rising

We dare you to join us.

Leave that list of fees behind and try Rising Dental Club’s superb, affordable, direct dental care. If a flat monthly fee for all your dental needs, and clear, transparent pricing for cosmetic procedures sounds splendid, give our team a call. 

Sign up and become a member today!

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