Going Out of Network: How to Market a Move Off PPO Plans Without Losing Your Practice

Dropping insurance networks stopped being a fringe idea some time ago. In the ADA Health Policy Institute’s State of the U.S. Dental Economy surveys, 35% of dentists said they intended to drop out of at least some insurance networks in 2026, and by the second quarter of the year 23.5% had actually done it. Insurance issues — low reimbursement, denials, delayed payment — sit at the very top of the profession’s list of frustrations.

The clinical and financial case usually gets made well by consultants. The part that gets skipped is the marketing case: when you leave a network, you lose the insurance company’s directory as a patient-acquisition channel, and you have to replace it. Practices that plan for that transition keep most of their patients. Practices that announce it in a letter and hope tend to spend the next year rebuilding.

Understand what you are actually giving up

An in-network listing is a lead source. Patients search their carrier’s provider directory, filter by distance, and call. It is passive, free and steady — and when you go out of network you lose it overnight, along with some share of price-sensitive patients.

So before the decision, quantify three things:

  • What percentage of your new patients came from the insurance directory versus Google, referrals, and your own marketing. Your front desk’s “how did you hear about us” data is imperfect but directionally useful.
  • What percentage of production sits with the plan you plan to leave, and how concentrated it is in a few families.
  • What your write-offs actually cost. The contractual adjustment number is what makes the case; it is also what tells you how much revenue you can afford to lose in patients before the move is a wash.

This is a marketing ROI exercise as much as a financial one — our framework for measuring marketing ROI from first click to lifetime value is the right lens.

Build the replacement channel before you send the letter

The single biggest mistake is sequencing. Practices notify patients, then start thinking about marketing. Do it the other way around: give yourself 60 to 90 days of visible, working patient acquisition before the transition date, so the new-patient flow that used to come from the directory is already coming from somewhere else.

That usually means three things running at once:

Change the message, not just the fee schedule

An out-of-network practice cannot compete on “we take your insurance.” It has to compete on outcomes, experience and trust — which means your brand and your website have to carry weight they may never have carried before. That is the whole argument in our post on building a premium practice identity.

Three messages do the heavy lifting:

  • “You can still use your benefits here.” Most patients believe out-of-network means no coverage. It usually does not — many PPO plans pay out-of-network benefits at a reduced rate, and you can file claims on the patient’s behalf. Say this everywhere, in plain language, or you will lose patients to a misunderstanding rather than to price.
  • “Here is what your visit will cost.” Publish real fees or ranges for common services. Transparency neutralizes the biggest objection and disqualifies the shoppers you no longer want.
  • “Here is what you get for it.” Longer appointments, no rushed hygiene, the same doctor every visit, technology you actually use. If none of that is true, do not go out of network yet.

Give patients a place to land: the membership plan

An in-house membership plan is the most effective retention tool in an out-of-network transition, because it gives uninsured and newly out-of-network patients a concrete alternative rather than a shrug. Preventive visits, x-rays and a discount on restorative work for a flat annual fee — priced so it is obviously fair — converts a difficult conversation into a simple offer. Our guides to membership plan marketing and growing membership plans cover pricing and promotion.

The communication sequence that keeps patients

Attrition in these transitions is driven far more by how patients found out than by the money. A workable sequence:

  • 90 days out: train the team. Every person who answers a phone needs the same two-sentence explanation and the same answers to the five questions patients will ask. Inconsistency here is what turns confusion into cancellations.
  • 60 days out: notify actively-treating patients personally — by phone or in person at their next appointment, not by mail. These are the relationships worth the time.
  • 45 days out: letter and email to the full affected list, written like a person wrote it: what is changing, why, what it means for their benefits, what their options are, and who to call.
  • 30 days out: update the website — insurance page, FAQ, membership plan page — and post the change to your Google Business Profile.
  • Through the transition: proactively schedule affected patients for treatment they have already accepted, and follow up on everyone who goes quiet. A patient who does not rebook is not a lost cause for at least a year; reactivation matters more in this period than at any other time.

Expect a dip, and plan the runway

Be realistic with yourself and your team: new patient volume from that plan drops immediately, some families leave, and the offsetting revenue from higher collections per procedure takes a few months to show up. Most practices that do this well plan for two or three quarters of transition, with enough cash reserve and enough marketing spend to bridge it. The practices that get hurt are the ones that cut marketing at exactly the moment they need it most — the mistake we describe in cutting your ad budget is not the problem.

Frequently asked questions

How many patients will we lose going out of network?

It varies enormously by market, plan mix and how long you have had those relationships, and any consultant quoting you a universal percentage is guessing. What is consistent is the driver: practices with strong relationships, clear communication and a membership alternative keep far more patients than practices that send a form letter.

Should we drop all plans at once?

Rarely. Most practices exit one plan at a time, starting with the worst reimbursement and the lowest patient concentration, and watch what happens to volume before the next step.

Do we still have to advertise if we are out of network?

More than before, not less. You have replaced a free directory listing with a market you have to earn. Budget accordingly — our dental marketing budget guide is a reasonable starting point.

Can we still submit claims for patients?

In most cases yes, and you should. Filing out-of-network claims on the patient’s behalf removes the paperwork objection, which is often the real objection.

The bottom line

Going out of network is a marketing project wearing a finance costume. The economics only work if new patients keep arriving, and the channel that used to deliver them disappears on day one. Build local search, reviews and paid acquisition first; explain benefits and fees in plain language; give patients a membership plan to land on; communicate in person with the people who matter most; and fund the transition through the dip.

Thinking about the move and want the demand side handled before you send the letter? Talk to our team.