PPO Solutions
Practice Purchases
PPO exploration, negotiation, set-up, and credentialing for your newly acquired practice.
What We'll Do
Buying A Practice Is One Of The Most Significant Investments You’ll Ever Make. How Will You Handle The Key Issues Of PPO Participation, Fee Schedules And Credentialing?
Purchasing an existing dental practice is the option many doctors choose to further their career. In doing so, the retention of patients whose records have just been purchased is paramount since they represent your expected profit as they have dental services over coming years.
For those patients, YOUR participation with THEIR insurance plan will likely be a factor in whether they will stay with the practice after the change in ownership. As frustrating as that may be, the reality is that many patients often make insurance participation a factor in choosing a new dentist or continuing with their existing dentist.
With professional assistance practice buyers can have the huge financial advantages and peace of mind that comes with knowing that the many options related to PPO participation are being explored, negotiated, credentialed and looked after on your behalf. As part of our service for practice buyers, Profitable PPOs can:
Provide information on UCR fees and area average charges for the most commonly done procedures
Handle negotiation of new PPO agreements and custom options
Explore and advise on the various options available for PPO participation
Handle credentialing, submission of applications and follow up on effective dates
Work with your in-office team to make sure there is clarity At Every Step
- The Importance Of PPO Participation
Should You Sign Up With The Same PPOs The Seller Had? If So, Should You Sign The Same Contract?
Many doctors don’t know that there are multiple ways to participate with many insurance PPO plans, and the fees can vary by huge amounts — an example, a $700 PPO fee on a crown versus a $1000 crown with the same company!
So, will you sign up for the same PPO plans, and in the same way, as the seller had? What will be the financial impact over your career if you don’t sign up in the most profitable way?
- Making A PPO Plan
Should You Add New PPO Plans?
What about negotiation and addition of new PPO plans — would that make sense?
In the dental insurance marketplace there are numerous PPO plans that have a significant presence. Would you, as a new practice owner, benefit by adding some new PPO plans if it helped you to attract more new patients?
At this key time of your career, as a new practice buyer, many doctors choose the option of professional assistance, and our services at Profitable PPOs can help!
FAQs
What Would Improving PPO Profitability Mean for Your Practice — and Your Life?
Many dentists feel stuck — working long hours, writing off thousands each month, and watching profits disappear due to low PPO fees. Profitable PPOs helps change that. Through our nationwide PPO negotiation and optimization program, we implement proven strategies to reduce write-offs and improve reimbursement so you can increase profits, reduce stress, enjoy your practice again, boost long-term practice value, and gain peace of mind about the future.
What's the typical time that PPO fee negotiation takes?
In most cases, 90 to 120 days is devoted to PPO fee negotiation time. Remember, fee negotiation is a long process because the insurance companies are not in a rush to improve or offer higher reimbursement and there are numerous obstacles to work through. Additionally, it is important to assess each offer as it comes in to determine the financial impact, but also to determine if staying with the PPO plan makes sense.
What is the typical time that PPO optimization takes?
The process of PPO optimization is almost always longer than just PPO negotiation because, while important, PPO fee negotiation is just one of many strategies that are typically pursued to improve PPO profits. We always remind dentists – the objective is to have the BEST result, and NOT the fastest!
What types of practices does Profitable PPOs work with?
Profitable PPOs offers services for dental specialists, multiple provider practices, multiple location practices, as well as solo practitioners. We also offer services for multi-specialty practices.
What if a practice does not know what PPO plans they are contracted with?
This is one of the biggest challenges for many dental practices looking for an integrative dental solution: they are in so many PPO plans that they do not even realize who, or how, they are in the various PPO networks! As part of the first stage we often review EOBs of PPO patients to accurately determine if the doctor is in a particular network, and if so, what fee schedule is being used. It is crucial however to have the fee schedules of the plans that the doctor has a direct lead contracted relationship with.
Will all insurance companies negotiate PPO fees?
Unfortunately, no. Not every company will negotiate fees. However, the good news is that many other options exist aside from PPO fee renegotiation, and thus the importance of a comprehensive approach to PPO Optimization, not just PPO renegotiation be considered.
Can our doctor or office manager make all of these PPO improvements internally?
In most practices, there simply isn’t enough time. Doctors are focused on patient care and clinical responsibilities, and office managers are overwhelmed with daily tasks like scheduling, billing, and benefit checks. PPO strategy and negotiation require time, expertise, and focus — which most in-house teams don’t have the capacity to take on effectively.
What Is The Difference Between PPO Negotiation And PPO Optimization?
PPO negotiation focuses solely on trying to raise your fee schedule — it’s one tool, and while helpful, it’s limited.
PPO optimization takes a broader approach, using multiple strategies to improve profitability. Think of it like clinical dentistry: you wouldn’t rely on just one type of filling. The more tools and techniques you use, the better the outcome, and the same goes for managing PPOs.
Are You At The Stage Where You Could Benefit From Professional Assistance With PPO Participation?
If you’re like most dentists, you may not love diving into PPO details, but you do know they have a massive impact on your profitability. Over your career, the difference between doing it right or wrong can mean millions of dollars gained or lost. At Profitable PPOs, we’re here to help you set up PPO participation in the most profitable way for your new practice — choosing the right plans, handling the paperwork, credentialing, and follow-ups — so you can focus on launching and growing your practice.
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Ready to Take Control of Your PPO Strategy?
Whether you’re running an established practice, launching a startup, or buying a practice, your PPO decisions directly impact your bottom line. The good news? There are smart, proven ways to participate more profitably—and we can show you how.