Fee for Service Academy

Fee for Service Academy Guiding Practices. Building Independence.

Fee for Service Academy helps established dentists transition away from insurance participation with preparation, sequencing, accountability, and a peer community.

The ADA has its own name for what the last six months did to the payroll conversation in a dental practice. Slide 33 of ...
09/14/2026

The ADA has its own name for what the last six months did to the payroll conversation in a dental practice. Slide 33 of its Q2 2026 economic update reads: "The 'fiscal squeeze' continues."

Here is the squeeze, in four numbers from a panel of 552 private-practice dentists.

January to June 2026:
Staff wages, up 2.2%
Inflation, up 1.8%
Collected per visit, up 1.1%
Equipment, up 0.2%

That third line is the one that gets misread. It is the Producer Price Index for what a practice collects per visit, averaged across every payer and including what patients pay out of their own pocket. It is the whole envelope, measured at the chair.

Widen the window and the gap widens with it. Since January 2021, collected per visit is up 19%, against 27% inflation and 23% staff wages.

That is the arithmetic sitting underneath every raise request in the country right now. An owner who cannot make the number work this year is reading the same page the ADA is reading.

Source: ADA Health Policy Institute, The State of the U.S. Dental Economy, Q2 2026 update, n=552 private practice.

Dropping an insurance plan is the last step in a fee-for-service transition, not the first. Everything gets built before...
09/12/2026

Dropping an insurance plan is the last step in a fee-for-service transition, not the first. Everything gets built before anything gets cancelled, and one of those things is a cash reserve.

Before the first plan is dropped, an established practice should hold four to six months of operating expenses in reserve. Fixed costs like rent, payroll, and lab don't fall when patient volume dips. Expect a J-curve: a dip, then a recovery. The reserve carries the practice across the dip.

If you want to see whether your practice is built to do this the right way, Fee for Service Academy, feeforserviceacademy.com.

09/11/2026

Alright, did you check your schedule? What number did you come up with?

Earlier this week, I asked you to see how quickly you could accommodate a referred new patient looking for a Tuesday morning or Thursday afternoon appointment.

There was a reason I asked.

If reducing insurance dependence or moving toward fee-for-service is somewhere in your future, your ability to make room for new patients matters.

In Part 2, I break down what your number might be telling you and why your schedule can be an important indicator of how prepared your practice is for growth.

Missed Part 1? Start here: https://www.facebook.com/share/r/1Ej29bvrYB/

Want to know if YOUR practice is ready?
At Fee For Service Academy, we help established dental practices evaluate their readiness, prepare for the transition, and strategically reduce their dependence on insurance.

Start PreQual Form Now: https://feeforserviceacademy.fillout.com/prequal-start
Learn more about FFSA: https://feeforserviceacademy.com/
Message Us on Facebook: https://m.me/feeforserviceacademy

09/09/2026

How quickly can your practice get a new patient in? 👀

Here’s the scenario Mark wants you to test:
A new patient is referred to your practice. They’re not in pain and want to schedule on a Tuesday morning or Thursday afternoon.
Pull up your schedule and find the first appointment you could offer them.

Then count the days.

How many days until you can get them in?
Drop your number in the comments below. 👇

If going fee-for-service is on your radar, now or in the future, this is a number worth knowing. And if you’re already fee-for-service, we’d love for you to play along and share your number, too.
Come back Friday for Part 2. Mark will dig into what your answer could be telling you about your practice and its ability to grow.

Considering a future with less insurance dependence?
Fee For Service Academy helps established dental practices determine whether they’re positioned for a successful fee-for-service transition and guides qualified practices through the process.

Want to know if you should consider dropping a plan or two?: https://feeforserviceacademy.fillout.com/prequal-start
Learn more about FFSA: https://feeforserviceacademy.com/
Message Us on Facebook: https://m.me/feeforserviceacademy

09/04/2026

New to Fee For Service Academy? Start here. 👋

If you’re thinking about transitioning your dental practice away from insurance participation, you don’t have to have everything figured out before reaching out.

Whether you’re ready to see if your practice might be a fit, prefer to talk things through first, or just have a quick question — there’s an easy place to start.

Choose what works for you:
✓ Complete our 10-minute pre-qualification form
✓ Schedule a 30-minute chat with Mark
✓ Send us a quick message

Learn more and get started at FeeForServiceAcademy.com

Three states have now written payment-method choice into law, and the practical question for a practice owner is a small...
09/02/2026

Three states have now written payment-method choice into law, and the practical question for a practice owner is a small one: what am I entitled to ask for?

Illinois — HB 4464, Public Act 104-0491. Signed 06/26/2026, effective 01/01/2027. Insurers shall provide a dental care provider with 100% of the contracted amount. A provider may not be required to accept only a credit card or EFT, or to incur a fee to access payment. A payment-method change requires the provider's express acceptance in writing. Any conflicting contract clause is void.

Wisconsin — 2025 Act 146. Enacted 04/02/2026, effective 04/04/2026. An insurer may not require a provider to accept a virtual credit card, must give notice of any fee and instructions for selecting another method, and may not charge a fee solely to transmit a HIPAA-standard ACH payment without the provider's consent. Non-waivable.

Georgia — HB 1374. Signed 05/05/2026, effective 07/01/2026. The ADA reports it moved the state from opt-out to opt-in: express consent is required before a plan pays by virtual credit card or by any method carrying a fee.

Wisconsin and Georgia cover healthcare providers generally; dental is included.

The ADA's guidance on EFT enrollment is the useful part for every state:

1. Ask specifically for a basic, fee-free option meeting the HIPAA ACH EFT standard.
2. Read the value-added tier carefully — auto-reassociation, expedited payment, practice-management integration. Third-party vendor charges live there. Decide on each one deliberately.
3. Check with your own bank. Some banks charge for incoming transactions, separate from anything the plan does.
4. Virtual credit cards run through card networks rather than the HIPAA ACH standard, so they more often carry processing costs.

Worth knowing: Delta Dental has stated that starting 1/1/2027 it will move to EFT as its standard payment method, which Delta describes as a fee-free payment method.

Fixing this is an afternoon of work, and it's worth doing. It's also the smaller of the two numbers on your ledger. The 25–35% written off under PPO participation is the one that decides what your practice is worth in fifteen years.

If you want to know whether your practice is a fit for a planned transition off those contracts, the Fee for Service Academy is at feeforserviceacademy.com.

"Busy and flat at the same time" is one of the most common things we hear from established owners.It rarely means you're...
09/01/2026

"Busy and flat at the same time" is one of the most common things we hear from established owners.

It rarely means you're doing something wrong. A practice that has plateaued is usually out of room on one of three capacities: time (the hours you'll work), space (chairs and operatories), or provider (you, your hygiene team, or an associate you may not even want). You can't out-work a ceiling you've already hit.

The move is to name which capacity is actually maxed, then raise that one deliberately — instead of pushing harder on the axis that still has slack. That diagnosis is step one of every transition we run.

If you want to see whether your practice is a fit, Fee for Service Academy — feeforserviceacademy.com.

Whose network are you actually in?Most dentists can name the PPOs they signed. Far fewer can name every entity now prici...
08/31/2026

Whose network are you actually in?

Most dentists can name the PPOs they signed. Far fewer can name every entity now pricing their claims off those signatures.

That gap has a mechanism behind it. Provider network contracts are commonly leased — a payer grants a third party access to the contracted fee schedule. Third-party administrators sit in the same category. One agreement, several parties downstream, all pricing off the same page.

Some states regulate the practice. Michigan's law, MCL 500.3406aa, took effect in 2023 and requires a contracting entity — the definition expressly includes third-party administrators — to:

disclose in writing, at contract entry or renewal, all third parties with access;
-maintain a public website list of those third parties, updated at least every 30 days and dated;
-have third parties identify the discount's source on remittance advices and explanations of payment where a discount is taken, subject to carve-outs;
-provide a copy of the provider network contract relied on in adjudicating a claim within 30 days of a written request from the provider;
-and honor a provider's decision to decline third-party access, without canceling the contract over it.

More than a dozen states regulate network leasing in some form, and the specifics differ state by state. Treat Michigan as one worked example. Confirm what applies where you practice.

What applies everywhere: the ADA's pre-signing checklist tells dentists to ask about the "affiliates" clause by name, and to obtain and carefully review all attachments, exhibits, appendices and undisclosed documents before signing.

A practice carrying 25–35% write-offs deserves to know which contracts produced them. Start with 60 days of EOBs and a highlighter.

We walk practice owners through this audit as part of the groundwork for going fee-for-service — because a contract you've never read is a contract you can't weigh.

feeforserviceacademy.com

A participation agreement is bigger than the pages you signed.It pulls in a provider manual, processing policies, exhibi...
08/28/2026

A participation agreement is bigger than the pages you signed.

It pulls in a provider manual, processing policies, exhibits and appendices — documents that govern how a claim gets paid, and that many practices have never been handed.

The ADA's pre-signing checklist for dentists asks two questions about this directly: how can the contract be changed once it is signed, and do you have the right to approve changes proposed by the other party. The same checklist instructs dentists to obtain and carefully review all attachments, exhibits, appendices and undisclosed documents before signing.

Most owners learn that a processing policy moved while they're reading an EOB.

Two things a practice owner can do:

Before the signature — get the whole document set, all of it, and read the modification language first.

After the fact — find out what your state gives you. Michigan's network-access law requires a payer to make available a copy of the provider network contract it relied on in adjudicating a claim, within 30 days of a written request from the provider. The ADA also reports that Indiana's 2026 law bars insurers from relying solely on automated systems to downcode, and requires individual review, a written explanation, and an appeals process.

Those rights tell you what happened. The decision about whether to stay in a contract you can't edit is still yours.

Fee for Service Academy helps practice owners make that decision on purpose instead of by default. feeforserviceacademy.com

Resigning an insurance plan is a procedure, and doing it precisely is what keeps the exit clean.Send the termination by ...
08/27/2026

Resigning an insurance plan is a procedure, and doing it precisely is what keeps the exit clean.

Send the termination by certified mail with return receipt, to the exact address in the contract, and follow the required notice window. It's commonly 30, 60, or 90 days, though some carriers require roughly six months. Notify by every available channel and record the representative's name and the date.

Then verify the removal independently. The contractual termination date is not the same as the directory-removal date, and the two rarely line up. Audit explanation-of-benefits statements for months afterward to confirm the practice was actually removed.

This is the kind of detail Fee for Service Academy walks practices through, step by step, feeforserviceacademy.com.

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