Insurance-based dental practices make treatment decisions based on what your insurance will cover. They maximize billable procedures, taking annual X-rays whether you need them or not, recommending treatments that might be premature, and often overlooking conservative approaches that could save your natural teeth. The system prioritizes speed and volume over thoughtful, personalized care.
Fee-for-service dentistry works differently. At Dental West NYC, we don’t make treatment decisions based on insurance coverage. Dr. Michelle Kamel and Dr. Leora Walter focus on what you actually need, when you need it. This approach means fewer unnecessary procedures, more time spent on prevention, and treatment plans built around preserving your natural teeth rather than replacing them.
What Fee-for-Service Dentistry Actually Means
Fee-for-service means we set our fees based on the quality of care we provide, not on what insurance companies reimburse. You pay for services directly, and we file insurance claims on your behalf as a courtesy. Your insurance may cover a portion of the cost, but insurance limitations don’t dictate your treatment plan.
This model differs fundamentally from in-network practices that accept insurance assignment. Those practices agree to reduced fees in exchange for being listed as preferred providers. To maintain profitability with lower reimbursement rates, they often need to see more patients per day and spend less time with each person. They may also recommend more procedures because they’re working within tighter financial margins.
Fee-for-service practices can spend more time with each patient. We’re not rushing through appointments to meet quotas. We can recommend conservative treatments even when more aggressive options might be more profitable. We can suggest waiting and monitoring a situation instead of intervening immediately. The business model supports clinical decision-making based on your best interests, not on insurance maximums or production targets.
How Insurance-Based Practices Differ
Insurance-based practices operate under contracts that significantly influence treatment decisions. When a practice accepts an insurance assignment, it agrees to fee schedules that are often substantially below its standard rates. They make up the difference through volume, which means shorter appointments and less individualized attention.
These practices also face pressure to maximize what insurance will pay. If your insurance covers annual X-rays, you’ll get annual X-rays, even if your oral health doesn’t warrant them. If a crown is covered but a more conservative filling might work, you may be steered toward the crown. The incentive structure encourages more treatment, not necessarily better treatment.
Insurance companies also limit what they’ll cover. Many policies don’t cover advanced technologies or techniques that could provide better outcomes. In-network dentists may not invest in equipment like the PerioLase MVP-7 laser because insurance reimbursement doesn’t adequately compensate for the investment. You end up with treatment options limited by what insurance deems “standard care,” which may be years behind current best practices.
Insurance-based practices often struggle with continuity of care. High patient volume means you might see different dentists or hygienists at each visit. Your treatment history becomes a series of notes in a chart rather than a relationship with a provider who knows your oral health patterns and personal preferences.
The Real Benefits of Fee-for-Service Care
Fee-for-service dentistry offers benefits that extend well beyond the financial transaction. The most significant advantage is time. Your appointments aren’t rushed. Dr. Kamel and Dr. Walter can examine you thoroughly, discuss findings in detail, and explain treatment options without watching the clock.
This extra time leads to more conservative treatment plans. We can identify problems early when less invasive interventions work. We can monitor borderline situations instead of immediately drilling and filling. We can spend time on prevention and education rather than just treating problems after they develop. Many patients discover that fewer procedures over time actually cost less than the cycle of treatments and retreatments common in high-volume practices.
Fee-for-service also means access to advanced technology and techniques. We invested in the PerioLase MVP-7 laser because it changes outcomes for patients with periodontal disease, not because insurance pays well for it. We use digital X-rays only when medically necessary, typically every two to two and a half years, because we can make that decision based on your individual needs rather than on annual insurance coverage.
The continuity of care matters tremendously. You see the same doctors and hygienists who learn your oral health history, your concerns, and your goals. They notice subtle changes that might be missed in a practice where you’re seen by whoever has availability. This relationship becomes the foundation for preventing problems rather than just fixing them.
Common Misconceptions About Fee-for-Service Dentistry
Many people assume fee-for-service means no insurance accepted or that it’s automatically more expensive. Neither is accurate. We file insurance claims for you. Your insurance covers whatever benefits your policy provides. The difference is that insurance limitations don’t restrict your treatment options.
Another misconception is that fee-for-service dentistry is only for wealthy patients. In reality, the model often results in lower lifetime costs because you’re not cycling through treatments and retreatments. Prevention and early intervention, which fee-for-service practices prioritize, typically cost less than emergency care and major restorations that result from neglect or inadequate treatment.
Some people worry that without insurance company oversight, fee-for-service dentists might recommend unnecessary treatment. The opposite tends to be true. Insurance-based practices have financial incentives to maximize billable procedures. Fee-for-service practices build their reputation on trust and results. Recommending unnecessary treatment would undermine the long-term relationships that make this business model successful.
The idea that all dental care is essentially the same regardless of practice model also deserves examination. Quality varies significantly. Materials, techniques, technology, and time invested all affect outcomes. Fee-for-service practices typically invest more in continuing education, better materials, and advanced equipment because they’re not constrained by insurance reimbursement rates.
Making Fee-for-Service Work With Your Budget
Fee-for-service doesn’t mean you pay everything out of pocket. Your insurance still provides benefits based on your policy’s coverage levels. We submit claims and work with your insurance company to maximize your benefits. The difference is that we don’t let insurance dictate what treatment you receive.
Many patients find that their actual out-of-pocket costs are comparable to or less than what they’d pay at in-network practices. Insurance-based dentists often recommend more treatment because they’re working within a volume-based model. Fewer, more appropriate treatments at fee-for-service rates can cost less than more frequent interventions at discounted rates.
We also work with you on treatment timing. Not everything needs to happen immediately. We can prioritize treatments based on urgency and your budget, spacing procedures over time when appropriate. This flexibility exists because we’re not pressured to maximize production each month.
For patients without insurance or with limited coverage, we offer transparent pricing and discuss costs before beginning any treatment. No surprises. No hidden fees. You know exactly what you’re paying for and why. Many patients find this transparency refreshing compared to the complexity of insurance explanations of benefits and unexpected bills.
What to Expect at a Fee-for-Service Practice
Your first visit to a fee-for-service practice typically lasts longer than appointments at insurance-based offices. We conduct a comprehensive examination, take necessary X-rays, and discuss your oral health history in detail. This thorough initial assessment helps us develop a treatment plan based on your actual needs.
Follow-up appointments also differ. Cleaning appointments aren’t rushed through in 30 minutes. Your hygienist has time to do thorough work and educate you about your oral health. If you have questions, there’s time to answer them properly. Doctor exams are equally unhurried. Dr. Kamel or Dr. Walter can explain findings, show you what they’re seeing, and discuss treatment options without pressure.
The treatment philosophy focuses on preservation. We look for ways to save teeth rather than replace them. We recommend the least invasive treatment that will be effective. We invest time in prevention because it’s better for you and it’s how we practice dentistry. This approach means you might hear “let’s monitor this” more often than “we need to treat this immediately.”
Experience Personalized Dental Care at Dental West NYC
Dr. Michelle Kamel and Dr. Leora Walter chose fee-for-service dentistry because it allows them to practice medicine the way they believe it should be practiced. Dr. Kamel’s advanced training in periodontics and implant dentistry from New York University, combined with Dr. Walter’s focus on restorative and preventive care, creates a practice built on clinical excellence rather than insurance contracts. They invested in advanced technology like the PerioLase MVP-7 laser because it improves patient outcomes, not because it maximizes insurance reimbursement.
Our Upper West Side practice operates on the principle that quality dental care requires time, attention, and expertise. We take digital X-rays only when medically necessary. We offer free fluoride treatments during cleanings because prevention matters. We focus on preserving your natural teeth through conservative, evidence-based treatment. The fee-for-service model makes this approach possible. Book online to experience dentistry focused on your health rather than on insurance maximums.
