Two-tier service model

A two-tier service model offers patients a genuine choice between two distinct versions of the same procedure: an insurance-level option that meets the standard of care using a more economical lab or material, and a premium option using newer technology, a same-day workflow, or a higher-end lab, each at its own separate fee. Ryan presents it as one of the more realistic ways for a PPO-heavy practice to reclaim some profitability without leaving insurance networks outright: the insurance fee fairly compensates the basic tier, and patients who want more can choose to pay for it.

The model depends on the two tiers being genuinely distinct, not a repackaged version of the same treatment at two different prices: a same-day CEREC crown from premium materials is a different product than a lab crown returned in two to three weeks, and patients need to understand and choose between real, different offerings rather than feel upsold on an identical result.

Rolling it out gradually (starting with a single procedure, training the team on how to present both tiers clearly and confidently) tends to work better than trying to convert the entire fee schedule to two tiers all at once.