Advice for Dentists under PPO: Negotiate by the Pennies

DentistDoctors are rock stars when it comes to saving and caring for their patients’ lives. But, more often than not, most dentists realize that it takes more than just medical knowledge to survive in the industry. In fact, a doctor’s everyday life revolves mostly around paperwork and dealing with insurance than the practice itself.

Today, Preferred Provider Organization (PPO), or insurance companies, who grant flexibility to its clients by not requiring a primary care physician, make up 80% to 85% of the medical insurance sphere. The reason for that: PPOs are more affordable than other health plans.

Everest Advocates, a team of PPO experts, shares how the medical cost-cutting solution of employers hurt the business of a modern dentist below.

Going on About this Dilemma

If you’re currently in a network of PPOs, let’s say you signed with three to five organizations, chances are you’re having problems determining which ones actually work. The reason: PPOs tend to share patients, which means your three to five providers probably has one and the same network that you don’t need.

With this realization, you can see that you have inefficiency issues right off the bat and you’re probably wasting your time complying and trying to deal with many PPO providers. To get out of this, you have to know your options well.

Prioritizing Those Who are Open for Negotiations

The best course of action for you or any dental practice is to revisit your PPO contracts and check whether there’s an option to negotiate. After that, you would want to send out a letter to express your wish to do so and increase your reimbursement fees.

Of course, you wouldn’t be able to accomplish that if you don’t know what your service worth actually is. So, determine first the average percentile of dental fees in your area and point out where your expertise lies.

Now, don’t be surprised when your PPO holds off on your proposal because as a business, they want to keep their profits at peak value as long as possible. But, given that you carefully screen your PPOs, it’s not impossible to cut a deal that works for both parties.

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