How Insurance Compliance and Price Fixing Fuel Bad Dentistry:

Corporate dental chains, largely run by non-dentists, are rewarded for one thing: compliance. As long as they follow insurance company rules, they keep getting patients—while reimbursements keep dropping. Lower payouts mean higher profits for insurance companies, but worse care for patients. 

In dentistry, that means cutting quality, upselling unnecessary work, and replacing skilled care with volume-based assembly-line treatment.

Dental insurance Network market control:

Insurance companies set artificially low UCR (Usual, Customary, and Reasonable) fees, particularly in areas with heavy DSO contracted network presence. This strategic suppression of reimbursement rates discourages independent providers and rewards high-volume chains. It’s price fixing in all but name.

• According to a 2021 report by the American Dental Association Health Policy Institute, insurance reimbursement rates have declined by an average of 5% over the past decade in markets dominated by DSOs.
• Average family health insurance premiums have increased by 52% over the past ten years (2014 to 2024), significantly outpacing inflation (~32%). KFF

Though this isn’t strictly dental-only, it reflects the general trajectory of premiums in employer-sponsored health plans, where dental coverage is often embedded.

Dentist employed by insurance companies to fight other dentist claims:

To make matters worse, insurance companies employ their own dentists—not to treat patients, but to review and deny claims. Even the most legitimate, well-documented treatments can be downgraded or denied by reviewers who have never seen the patient. This system is designed not to reimburse, but to delay and discourage treatment, pushing patients back into the contracted network of "preferred providers-chain-corporate-DSO" who accept low fees in exchange for volume.

Finding a way to do a $10 job for .25 cents is not possible!!!

• The National Association of Dental Plans (NADP) highlights that over 60% of dental plans restrict patient choice by limiting in-network providers.

What this means for you: If you go to an in-network provider, you may not get the honest care you actually need—because they often can’t profit from it. Instead, you’re more likely to be unnecessarily referred out to specialists (where the chain or in-network dentist may profit from referral “kickbacks”), or pressured into treatments you don’t really need—simply because that’s where the money is.

And remember—insurance companies only sell policies loaded with small print and empty promises. After that, YOU are left to track down some so-called “in-network preferred provider” (nice sales language, isn’t it?) to actually do the dental work. These offices are usually not run by owner-dentists. The dentistry is often performed by independent contractors working on commission under insurance’s rediculous fee schedules. That means they pick and choose which cases are “worth their time,” instead of focusing on what’s truly best for you.

Quality Dentistry Takes Time — But DSO/ franchise Quotas and High Volume Don’t Mix:

Good dentistry takes time, skill, and attention to detail. Unfortunately, under the high quotas and volume demands of most dental franchises and DSOs, these two essentials are often at odds.

There comes a point where the “product” simply can’t be made within the cost constraints which we are rapidly approaching with this mode of oporataion.  It’s like trying to manufacture a quality car on a motorcycle budget.

So what is the “motorcycle market” for dentistry? It’s a one-size-fits-all approach, often driven by insurance agreements, referral kickbacks, and profit margins benefiting the DSO rather than patient well-being.

• The National Association of Dental Plans (NADP) highlights that over 60% of dental plans restrict patient choice by limiting in-network providers.

Don’t let insurance -corporate DSO limitations dictate your dental care. This is why independent dentists who control their materials, labs, and treatment decisions provide care that is more thorough, tailored, and trustworthy.

Contact us to learn how we offer transparent  quality care without compromise.