UNDERSTANDING PPOS

Dental PPO’s are a relatively straightforward concept – a dentist becomes contracted as a “preferred provider” with the insurance company and typically agrees to provide dental care at reduced fees to people who have a policy with the contracted insurance company. By doing so the practice obtains preferred access and exposure to the patients from that company, usually by being listed on the insurance company website or booklet of preferred providers. Then, when potential patients who have that insurance need to find a dentist, they will be able to find the contracted preferred provider doctor.

The Upside of PPO’s

Participating with Dental PPO’s can be a great way to build a practice – it can both help you attract new patients as some insurance companies have very large membership in certain areas through employers, military, government, local unions and the like. PPOs can also help a practice retain those patients once they’ve visited, as patients know they might not receive the same level of cost savings if they were to leave and go to another doctor. For a young doctor starting a practice this can be an attractive way to bring in new patients without spending huge upfront marketing dollars. And for a more established practice that wants to provide practice stability, continue to grow, or even prepare for an associate dentist to join the practice, participation with PPO’s can be a successful strategy.

The Downside of PPO’s

Like many things, participation with dental PPO’s has some trade-offs. The most obvious one being that the discounting of fees to attract PPO patients can be a profitability killer if the number of patients brought in doesn’t more than offset the discounts that have to be provided. There are situations where participation with PPOs has resulted in doctors receiving 70% OFF their usual fee and doing so month after month after month, make it extremely difficult to be profitable. One way to view participation with PPO’s is as a marketing expense – you’re relying on the insurance companies to help you attract new patients and then retain those patients. Unfortunately, this can be a very expensive marketing expense — you give up a percentage of your profits on each and every visit the PPO patient makes to your practice, year after year!

The PPO Dilemma

For many dentists who participate with PPO’s they find themselves in a difficult position:
  • They need patients to treat in order to keep the business going and earn their paycheck
  • They find it harder and harder to earn a profit as they are treating more and more patients at low fees.
The thought of no longer accepting PPOs can be a tantalizing one, but can also have scary ramifications….if a practice quits participation with the insurance company PPOs then fees will go up! But will there be any patients?

There Are Solutions

Fortunately there is another option – optimization of PPO’s and how they are handled! Simply, this means optimization of the systems and revenue generated on PPO patients, understanding which PPO’s are profitable, or can become profitable, and participating with them, while dropping PPO’s that cannot be made profitable, structuring your fees appropriately, improving PPO fees, benefiting from fee options you have that are state specific and other strategies. When this happens a practice can improve the profitability of PPO’s by 10% to 50% or more!

Learn More Today

If you’d like to learn how Profitable PPO’s can help you to minimize PPO write-offs and improve profitability so that you have less stress and greater peace of mind about your practice, then take the next step now and simply provide your contact details and we’ll send you additional information!

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