Why some dental practices don't take insurance, and why it can still cost less.

The short answer.

Practices that opt out of insurance networks ("non-participating" or "out-of-network") have made a deliberate choice to set their own fees rather than accept the reduced reimbursement schedules insurance companies require for network participation. They typically still submit claims to your insurance company on your behalf as a courtesy, and the reimbursement comes to you directly.

Net cost to you can be higher, comparable, or sometimes lower than at an in-network practice, depending on your specific plan, the procedure, and the practice's fee structure. The only way to know for sure is to ask for a written estimate before treatment. Full detail on how Dunning handles billing lives on the insurance and payment page.

What "in-network" actually costs the practice.

When a dental practice joins an insurance company's network, the practice agrees to charge that insurance company's approved fee for each procedure, not the practice's own fee. The approved fee is typically 30–50% lower than what the practice would otherwise charge. The insurance company gets predictable pricing for their members; the practice gets steady patient volume in exchange.

To stay financially viable at those reduced rates, in-network practices typically have to compensate in three ways:

• Faster appointment pace, less time per patient, more patients per day.
• Less time on patient education and conversation, the longer conversations that build trust take time the billing model doesn't reward.
• More volume in procedures that have better insurance reimbursement, which can subtly tilt treatment recommendations toward what insurance pays well rather than what each patient most needs.

None of this means in-network practices are bad, many are excellent. But the structural pressures are real, and different practices respond to them differently.

Why some practices opt out.

Practices that opt out of insurance networks typically do so because they've decided the trade-offs of network participation conflict with how they want to practice. Specifically:

• They want enough time per patient to do thorough exams, conversations, and treatment planning without rushing.
• They want treatment recommendations to be based on what the patient actually needs, not what insurance pays well.
• They want to keep doctor continuity (one dentist, same patients, year over year) rather than the higher-turnover models that volume-based practices often require.
• They want to use specific materials, labs, and procedures that may not be the cheapest option the insurance company would approve.

Dunning Family Dental made this choice years ago and explains it directly on the about page and the insurance and payment page. The choice isn't ideological, it's about keeping the pace and the integrity of how the practice runs.

How the billing actually works (and why it can net out comparable).

At a non-participating practice like Dunning, the billing flow is:

1. You're seen and treated.
2. Before any treatment beyond a basic exam, you get a written estimate including the practice fee and an estimate of what your insurance is expected to reimburse.
3. You pay the full practice fee at the visit (cash, check, credit card, HSA/FSA, or CareCredit).
4. The front desk files the insurance claim on your behalf within 24–48 hours.
5. Your insurance processes the claim and sends a reimbursement check directly to you, usually within 2 to 4 weeks.

Net cost to you = practice fee − insurance reimbursement. Whether this is more, less, or comparable to an in-network practice depends on your specific plan and procedure. Some plans reimburse non-participating providers at the same rate as in-network providers (which means the net cost difference can be small or zero). Other plans reimburse at lower rates for out-of-network, which makes the difference more visible. The only way to know is to ask the front desk for an estimate based on your specific plan.

Practical questions to ask any dental practice.

Whether you're considering an in-network or non-participating practice, these are the questions worth asking before you commit to a first visit:

• Do you submit insurance claims on my behalf, or do I file them myself?
• Based on my specific plan, what's a realistic out-of-pocket cost for a typical first visit (cleaning + exam)?
• For larger treatment (crowns, root canals, implants), do you provide written estimates before starting?
• If something costs more than estimated, who eats the difference?
• Do you accept HSA/FSA cards, CareCredit, or payment plans?
• What's your policy if I can't afford the recommended treatment all at once?

A reasonable practice will answer all of these in about five minutes on the phone. If you can't get clear answers, that itself is information. The full breakdown of how Dunning handles each of these questions lives on the insurance and payment page, and the new patients page walks through what to expect from the first visit forward.