Fee-for-Service Dentistry
Understanding Out-of-Network Dental PracticesIf you’ve ever been told a dental office is “out-of-network” or “fee-for-service,” it can raise questions. Does that mean insurance isn’t accepted? Will it cost more? How does payment actually work?
The reality is more nuanced, and often more patient-focused than people expect.
At Galligan Family Dentistry, we operate as a fee-for-service (FFS), non-participating provider, and we do so intentionally. Not to make things more complicated, but to provide care in a way that prioritizes patients, not insurance contracts.
What Is a Fee-for-Service Dental Practice?
A fee-for-service practice sets its own fees based on the quality of care, materials, time, and expertise required to do the job right.
We are not bound by insurance company fee schedules or restrictions on how care is delivered. That allows us to focus on what is best for the patient, not what is pre-approved or reimbursed at a lower rate.
In a fee-for-service model, treatment decisions are made between you and your doctor. Not dictated by an insurance company.
What Does “Out-of-Network” Mean?
Being out-of-network means we do not have a contractual agreement with insurance companies that sets fixed, reduced fees.
However, this does not mean you cannot use your insurance.
Most dental insurance plans still provide out-of-network benefits, meaning they will contribute toward the cost of your care even if we are not contracted with them.
The difference is that the insurance company reimburses based on their own internal fee schedules, which may not reflect the actual cost of high-quality care.
How Most Fee-for-Service Offices Handle Insurance
In many fee-for-service practices, patients are expected to:
- Pay the full cost of treatment upfront
- Submit their own insurance claims
- Wait to be reimbursed directly by their insurance company
This approach is common, but it can feel like a burden for patients.
How We Handle Insurance Differently
We’ve chosen a different path.
We have a dedicated team that handles insurance claims on your behalf, regardless of the provider.
That means we:
- File your claims for you
- Track and follow up on those claims
- Collect insurance payments directly from your carrier
- Apply those payments to your account
Our goal is to make using your insurance as seamless as possible, even though we are out-of-network.
How Payment Works in Our Office
While many fee-for-service offices collect the full fee upfront, we take a more patient-friendly approach.
At your visit, we:
- Verify your benefits
- Estimate what your insurance is expected to cover
- Collect only the estimated patient portion at the time of service
We also keep a payment method on file as part of that process.
As a courtesy, we do not charge any remaining balance for 30 days, allowing time for your insurance to process and pay their portion. Once the claim is finalized, any remaining balance is settled based on the actual insurance payment.
This approach allows you to receive high-quality care without having to front the full cost and wait for reimbursement.
Why Many Practices Choose to Be In-Network
In-network practices agree to pre-set fee schedules established by insurance companies.These contracted rates are often significantly lower than standard fees.
To make up for that difference, many in-network offices must:
- See a higher volume of patients
- Shorten appointment times
- Operate on tighter margins
For patients who are primarily focused on minimizing out-of-pocket cost, this model can be appealing.
It’s also important to understand how in-network offices handle patients with plans they do not participate with.
Some practices simply do not accept those patients at all.
Others will still see you, but because they are not contracted with your specific insurance, they effectively treat your visit as out-of-network or fee-for-service. In those cases, patients are often required to pay the full cost upfront and handle their own insurance claims and reimbursement.
That experience can look very different depending on the office, and it is not always clear to patients until after the visit.
Why We Choose to Remain Fee-for-Service
We believe dental care should be built around the patient, not the limitations of an insurance contract.
Remaining fee-for-service allows us to:
- Spend the time needed with each patient
- Use high-quality materials and techniques
- Focus on long-term outcomes, not short-term fixes
- Provide a more personalized, relationship-based experience
In many high-volume, insurance-driven environments, patients can begin to feel like a number. Appointments are faster, decisions are more constrained, and care can become more transactional.
That is not the experience we want for our patients.
The Trade-Off: Cost vs. Control
There is a trade-off, and it is important to be clear about it.
Being out-of-network may result in higher out-of-pocket costs compared to an in-network office, depending on your insurance plan.
But in return, you gain:
- Greater flexibility in treatment options
- More time and attention during visits
- Care that is not limited by insurance restrictions
- A team that advocates for your health, not your plan
For patients who value quality, consistency, and a more personal experience, this model often aligns better with their expectations.
The Bottom Line
Being a fee-for-service, out-of-network practice does not mean we don’t work with insurance. It means we are not controlled by it.
We still help you use your benefits. We still file and manage your claims. We still work to maximize what your plan provides.
But we do it in a way that allows us to deliver care on our terms, with your best interest at the center of every decision.
If you live in Wake Forest, North Raleigh, Rolesville, Youngsville, or the surrounding Wake County area, and want a more personal, transparent approach to dental care, we’re here to help.
Call our office or schedule online to get started.