How to Grow a Fee-for-Service Dental Practice Out of Network (With Associates): Lessons from Dr. Andrew Kokabi

If you’ve ever wondered whether you can grow your dental practice without playing the insurance game, you’re not alone. Many owners assume that building a dental practice with real scale requires PPO participation, high-volume scheduling, or constantly chasing lower reimbursements.

But on the Dental Practice Heroes Podcast (and Dental Practice Heroes podcast listeners know this well), we’re focused on systems, leadership, and sustainable growth. This episode highlights a powerful example: Dr. Andrew Kokabi grew from a solo dentist into an 11-operatory fee-for-service practice with multiple doctors and high monthly new patient numbers while staying out of network.

That’s not luck. That’s dental business management, intentional dental patient management, and strong practice culture.

In this dental practice guide, we’re breaking down the exact strategies he used so you can apply them in your own running a dental practice journey, whether you’re looking for dental coaching, exploring dental practice coaching, or simply trying to increase dental practice revenue without adding more stress.

Why Out-of-Network Growth Works (If You Build the Right Systems)

A lot of owners want the benefits of fee-for-service: better margins, fewer write-offs, and more autonomy. But they don’t know how to create enough demand to support it.

Dr. Kokabi’s story is a reminder that practice growth for dentists is rarely about a single marketing trick. It is about stacking trust-building systems over time.

If you want dental practice growth without insurance participation, your strategy has to answer two questions:

1. Why should patients choose you when you’re not in network?

2. How will your practice consistently deliver an experience worth paying for?

That’s where dental practice operations systems and consistent messaging become the differentiator.

Start With Trust: The Foundation of Fee-for-Service Dental Patient Management

Dr. Kokabi didn’t describe himself as the fastest or most naturally talented clinician early on. What he did emphasize was his ability to make patients feel comfortable and cared for, an underrated superpower for fee-for-service practices.

This is dental patient management at its highest level: not just chairside rapport, but building an environment where patients willingly invest in care because they trust the team.

If you’re trying to grow dental practice numbers out of network, here’s a simple truth:

Patients don’t pay premium fees for dentistry. They pay for certainty, comfort, and trust.

That is the real marketing in a fee-for-service model.

The Capacity Trap: How to Grow Without Burning Out

One of the most important lessons from this conversation is how growth creates new constraints.

Dr. Kokabi started with three operatories and a practice still using paper scheduling and typewritten claims. He didn’t take home a paycheck his first year. Over time he expanded to five operatories, and eventually to eleven.

This highlights a key principle in dental business coaching and dental practice management coaching:

Growth requires capacity planning, not hustle

If your schedule is full, your hygiene is booked, and you still want to increase dental practice revenue, you don’t need more effort. You need:

• Physical capacity (operatories)

• Team capacity (hygiene and assistants)

• Operational capacity (systems and training)

This is where many owners hit a wall and dentist burnout solutions become urgent instead of optional.

Adding Associates Without Losing Quality: Associate-Driven Practice Done Right

Dr. Kokabi’s transition from solo dentist to multi-doctor practice wasn’t easy. His biggest challenge wasn’t clinical. It was ensuring consistency between doctors.

That’s the real issue behind dentist associate recruiting and management:

If two doctors diagnose and communicate differently, patients lose confidence fast.

Dr. Kokabi solved this by creating a clear framework for associate onboarding, including:

• The practice philosophy and standards

• Treatment planning examples

• How the practice communicates with patients

• What the practice stands for culturally

That approach is exactly what separates a chaotic associate model from an associate-driven model that creates freedom.

If your goal is reduce clinical days for dentist owners and improve dentist work-life balance, you need a structure that lets you step back without the practice losing momentum.

That’s how owners get closer to dentist financial freedom, not by working more, but by building a practice that runs consistently without them.

Community-Based Marketing That Actually Builds Demand

Most practices do some community stuff. Dr. Kokabi doubled down and turned community involvement into a strategic growth engine.

1) Brighten Your Smile, Better the World Campaign

Instead of selling whitening traditionally, he created a monthly community partnership:

• Patients donate (example: $150) to a local nonprofit or school

• They receive whitening trays (normally $400) as a thank-you

• The nonprofit gains money and visibility

• The practice gains goodwill and word-of-mouth growth

This is a powerful example of dental practice culture improvement becoming marketing, not a separate initiative.

2) Spotlight on Small Business Initiative

Dr. Kokabi used TVs in ops and the waiting room to promote patients’ businesses for free, creating a flywheel:

• Business owners feel valued and refer

• Patients see familiar faces and feel socially reassured

• The practice becomes a community hub, not just a dental office

This is the kind of practice identity that makes fee-for-service growth sustainable.

Leadership and Mindset: The Real Key to Growing Out of Network

Dr. Kokabi shared a message many owners need to hear: you don’t have to be perfect clinically to build a great practice.

You need belief, consistency, and leadership.

That’s why dentist leadership training matters as much as clinical CE if you want true growth.

The best leaders in dental practice management don’t just do dentistry. They shape culture, define standards, and create systems that make excellence repeatable.

That’s what turns a solo office into a scalable organization, what some would call dental heroes or heroes dental thinking: building something bigger than yourself.

How This Fits Into Dental Practice Books and Coaching

If you’re the kind of owner who reads dental practice books, searches for books on dental practice management, or has considered a dental practice consultant, this episode reinforces the same core ideas:

• Clarify your position in the market

• Build systems for patient experience

• Train your team to communicate consistently

• Plan capacity before you hit the wall

• Recruit associates with standards, not hope

It’s not about copying one tactic. It’s about installing the structure that supports growth.

That’s the work of dental coaching and dental practice coaching: helping owners build a machine that creates freedom.

Conclusion: You Can Grow a Large Out-of-Network Practice, If You Build for It

Growing a multi-doctor, fee-for-service practice out of network isn’t just possible. It is repeatable when you focus on systems, leadership, and community trust.

If you want to grow your dental practice, improve dental practice profitability, and create a path toward clinical day reduction dentist owners are chasing, the blueprint is clear:

• Build trust intentionally

• Expand capacity strategically

• Install consistent associate standards

• Market through community identity, not discounts

• Develop leadership that scales beyond you

That’s what this episode of the Dental Practice Heroes podcast demonstrates, and it’s a reminder that the best growth strategy is often the one that makes your practice indispensable to your community.

If you want more frameworks like this, keep following the Dental Practice Heroes podcast and explore resources that strengthen your systems, messaging, and leadership because sustainable growth isn’t a mystery. It’s built.