Dentrix Insurance Setup Tips (Replay): How to Prepare Your Practice for Going Out of Network

In case you missed it, this is a replayed moment from last year and one of the most listened-to podcast episodes because so many dental practices are making big decisions about insurance participation. If your practice is going out of network with insurance plans, your Dentrix setup needs to change with you.

Listen on Apple Podcasts: 

Listen on Soundcloud:

Over the last year, I have had more and more dental offices reach out because they are making the decision to go out of network with insurance companies.

And one of the biggest questions I hear is:

“What do we need to change inside Dentrix?”

Because here’s the thing…

Leaving an insurance network does not magically update your Dentrix software.

I wish I had a magic wand that could fix everything with one click, but unfortunately, that button does not exist.

Your Dentrix insurance setup needs to be adjusted so your treatment plan estimates, ledger fees, and patient conversations match your new out-of-network workflow.

Understanding Your Current Dentrix Insurance Setup

Before you make changes, you need to understand how your insurance plans were originally set up.

Most in-network practices use one of two methods:

Fee Schedule Method

With the fee schedule method, your contracted insurance fees are entered into Dentrix and linked directly to the insurance plan.

This means Dentrix posts the contracted fee to:

• The patient ledger
• The treatment plan

Your coverage table then helps calculate the insurance estimate.

When everything is set up correctly, this method can create very accurate patient estimates.

Allowed Amount Method

The allowed amount method works differently.

Your practice posts your full office fee to the ledger and treatment plan, but Dentrix calculates estimates based on the contracted insurance amount entered into the allowed amount column.

Both methods work when you are in network.

But when you leave the network, those settings need attention.

Watch it on YouTube: 

Going Out of Network? Update Your Dentrix Fee Schedules

If you have been using fee schedules, one of the most common questions I get is:

“Is there a global button to remove all fee schedules from insurance plans?”

Unfortunately, no.

There is no magic button.

But there is a way to buy yourself some time.

One option is copying your full office fee schedule into the insurance fee schedule you are no longer contracted with.

For example, if you are leaving Delta Dental, you could copy your full office fees into your Delta Dental fee schedule.

This allows Dentrix to begin posting full fees while you work through updating individual insurance plans.

Long term, you will still want to unlink those fee schedules from your insurance plans.

Don’t Forget to Update Existing Treatment Plan Fees

This is the step many teams miss.

Changing your insurance setup does not automatically update existing treatment plans.

If treatment was already entered while the old fee schedule was connected, those old fees may still be attached.

You have two options:

You can update treatment plan fees globally through fee schedule maintenance.

Or you can update them patient by patient as they come in.

If you choose the global update option, I recommend doing this outside of patient hours because larger databases may take time to process.

Updating Dentrix When Using the Allowed Amount Method

If your practice used the allowed amount method, your cleanup process will look different.

Remember, your allowed amount column was helping Dentrix estimate based on your contracted insurance fees.

But now that you are out of network, those numbers are no longer accurate.

You will need to:

• Open the insurance benefits and coverage area
• Review the payment table
• Clear outdated allowed amounts
• Update coverage information

This helps Dentrix calculate based on your new out-of-network setup.

Better Dentrix Setup Creates Better Patient Conversations

The reason this matters is not just because of numbers on a screen.

Your Dentrix setup impacts your entire patient experience.

Accurate information helps your team:

• Create better treatment estimates
• Collect more accurately on the day of service
• Reduce confusion at checkout
• Have more confident financial conversations

One of the biggest reasons I want your Dentrix insurance setup to be accurate is because it directly impacts how you present treatment to your patients. If your estimates are confusing or inaccurate, it can create unnecessary barriers when patients are trying to make decisions about their care.

If you want to dive deeper into creating better treatment estimates and improving case acceptance, read:
👉 Dentrix Insurance Estimating Tips: Fee Schedules, Downgrades & Accurate Treatment Plans

Protecting Your Cash Flow During Insurance Changes

Going out of network is not just a Dentrix setup change. It impacts your entire revenue cycle.

Your team needs to understand:

• What patients owe
• When payments should be collected
• How insurance estimates are communicated
• How outstanding balances are managed

Because when your financial systems are unclear, it impacts your collections and your patient experience.

For more strategies on improving collections using Dentrix, read:
👉 Increase the Cash Flow With Your Dentrix Software

Your Dentrix System Needs to Match Your Practice Model

Going out of network is a big decision, and your Dentrix software needs to support that change.

Your practice management software is the foundation of your systems.

Dentrix can do the math.

But we have to give it the right information.

This is exactly why your daily, weekly, and monthly Dentrix workflows matter so much. Your software is only as accurate as the information your team enters and the systems you build around it.

If your team needs help creating stronger routines, I recommend reading:
👉 Building Rock-Solid Dentrix Workflows: Daily, Weekly, and Monthly Systems That Actually Work

Take the time to clean up your insurance setup, review your fee schedules, and make sure your team understands the new workflow.

Because when your Dentrix setup matches your practice goals, your team can spend less time fixing problems and more time taking care of patients.

FAQ: Dentrix Setup When Going Out of Network

What should I update in Dentrix when going out of network?

You should review your fee schedules, insurance plan settings, treatment plan fees, coverage tables, and allowed amounts to make sure Dentrix reflects your new out-of-network status.

Do Dentrix fee schedules automatically update when I leave an insurance network?

No. Dentrix does not automatically remove or update fee schedules. Your team must manually update your insurance setup.

What happens if I forget to update treatment plan fees?

Existing treatment plans may still show old contracted fees, which can create inaccurate patient estimates and collection issues.

Should out-of-network practices still use insurance estimates in Dentrix?

Yes. Dentrix can still help estimate insurance benefits, but your setup needs to reflect your current relationship with insurance plans.

What is the difference between fee schedule method and allowed amount method in Dentrix?

Fee schedule method posts contracted fees directly, while allowed amount method posts full fees but calculates estimates based on contracted insurance amounts.

Thinking about going out of network and not sure if your Dentrix setup is ready? Schedule a discovery call and let’s make sure your systems, estimates, and workflows support your next chapter.