PPO Improvements

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What Would Improvement in PPO Profitability Mean To Your Stress Level, Your Practice, And Your Life?

Do you know how some dentists who accept dental insurance PPOs feel frustrated with the effects of having bad fees dictated to them by the insurance companies, and low profit margins that cause them to write off tens of thousands of dollars every month? 

Sadly, that means these dentists often go home frustrated, they lack enthusiasm for dentistry, they feel trapped in their practices, often work long hours and they are constantly worried about money because of the low-fee PPOs! 

At Profitable PPOs, what we do is offer a nationwide PPO negotiation and optimization program for dentists and dental specialists who accept PPOs. This means that we work with them on key strategies which have been proven to reduce PPO write-offs. 

What are the benefits of a comprehensive approach to PPO optimization? 

  • Greater peace of mind about the future
  • Less stress
  • Increased enjoyment of their practice
  • Improved practice value
  • Higher PPO fees that result in improved profit


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.

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!

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.

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.

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. 

One of the challenges facing dental practices when dealing with dental PPOs is the lack of available time and focus. For the doctor, time is very limited with patient care, reviewing notes, hygiene checks, preparing for patient care, leading, etc., it does not leave much free time! And frankly, very few doctors understand dental insurance well!

For an office manager or insurance coordinator the daily responsibilities (answering the phone, assisting patients, developing treatment plans, checking benefits, financial arrangements, scheduling, and collections, etc.) make it very difficult to study the different PPO relationships between insurance companies – there simply aren’t enough hours in the day!

When thinking of improving PPO fees many dentists, look at it from the perspective of strictly renegotiating the PPO fees. While negotiating PPO fees is a good strategy, using either the service of a dental PPO fee negotiator or by the doctor or office manager after) it is just one approach to improving PPO fees.

Unfortunately, utilizing a PPO fee negotiation only strategy is sort of like a doctor deciding they are only going to use amalgam fillings. Would you rely only on amalgam fillings in your practice? Of course not!

Conversely, PPO Optimization uses many techniques —- relying on numerous ways to improve profit. This approach is akin to a doctor who can do inlays, onlays, crowns, gold, amalgam, silver, implants, etc. The more options that can be considered, and used, the better the outcome will be! 

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Is PPO Participation Important?

In today’s marketplace participation with dental insurance PPO’s is an important factor for many practices, because more than ever, patients have made in network status a key criterion when choosing a new dentist or continuing with their existing dentist.

With the increased emphasis for patients to visit a preferred provider, the number of Dental PPO plans has grown dramatically – as has the level of complexity, the relationships between insurance companies, and shared networks.

Especially troublesome for many practices are the shared networks where a doctor joining one plan will be put into several other affiliated networks, often without even being aware what those other insurance networks will be!

The Tragic Result

Even though participation with dental PPOs is typically a huge expense for a dental practice, with the level of complexity and the lack of time that most front desk personnel have, the issue of PPO profitability doesn’t receive consistent, or focused improvement efforts….

Without consistent and focused effort what happens? Well the dental practice is at the mercy of the insurance company, must work harder than ever to offset bad PPO fees, and misses out on opportunities – – sometimes HUGE opportunities – to increase PPO fees and profitability!

With this realization many dentists seek help. At Profitable PPOs, as dental PPO fee negotiator and PPO optimization specialists we work with practices across the United States to apply a set of proven strategies that make practices more profitable – and enjoyable – for the dentist.

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Key Strategies To Improve PPO Profitability Include:

  1. Increasing profit by strategically setting UCR fees 
  2. PPO fee negotiation to improve profit 
  3. In-depth assessment of PPO plans to allow data-driven decision making  
  4. Utilizing network sharing contracts 
  5. Improving profit by utilizing state laws pertaining to PPO reimbursement 
  6. Adding high fee PPO plans to help attract more profitable patients
  7. Ending participation with low fee PPO agreements
  8. Eliminating common, and costly, PPO errors
  9. Configuring optimal reimbursement in multi-doctor practices

Ready to learn more?

If you would like to schedule a no-cost, no obligation, consultation call to discuss how Profitable PPOs can help we are happy to do so, simply contact us through the button below.

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