4 Real Benefits of PPO Optimization in 2018

by | Apr 2, 2018

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What Are the Real Benefits of PPO Optimization?

by Kristan Palmer

PPO Fee Negotiations are not what they used to be. Over the past 5 years, the dental insurance industry has combined and merged through leasing arrangements that make it nearly impossible for a practice to negotiate adequate fee increases without the help of an expert. There are thousands of possible leasing configurations available, and by default, you’re likely accepting the lowest possible arrangements. It’s important to understand just how beneficial optimizing your PPO participation can be.


A Better Understanding

You remember us talking about “thousands of leasing configurations”, right? By default, the configuration or leasing you are currently using (and may not even realize), is automatically routed to the lowest paying option. Our team understands the back end of insurance, loop-holes and traps better than anyone in the industry. We know that the only way to see the best results is to review every inch of current and potential participation to find the best leverage. The knowledge and education you’ll gain from the service will benefit you and your staff indefinitely!


Immediate Returns

The obvious benefit of higher PPO fees is the immediate return. Our average single provider client with current PPO participation sees a 10x return on their initial investment based on 1 year of revenue. For most clients, this means about $50,000-$70,000 in NEW revenue annually. We recently reviewed a client’s revenue after concluding services and identified $400,000 in NEW revenue…. That’s right! 1 provider, 65x return on investment, 400k in new money every year! Do you have other investments providing that kind of return?


Room for Growth

Optimizing fees goes beyond negotiations. Strategically structuring contracts in the most profitable way is where the most profound improvements are made. With higher collections, more cash flow and the right participation you may consider adding associates, who will also qualify for the same great fees when they join your practice. Maybe you’re looking to spend a little more time away from the chair or adding another location. When you maximize your participation, you’ll find things like this are now in reach.


A More Valuable Asset

Here’s the one that’s overlooked most. As a dentist, you wear many hats, but you do own a business and major asset. Your entity is only as valuable as your day to day production. Most dental practices are valued using equations related to annual revenue and associated profits. If you can increase your revenue and profits, you’re increasing the value of your asset! Maybe you’re close to retirement, maybe you’re just starting your career, but it’s always a great time to build a more valuable business for your future!

Negotiating on your own will never yield results worth the effort… Insurance carriers may offer you something, but is 1-2% covering inflation you’ve seen over the last several years? What about the next 2 or 3 years? Accepting a sub-par fee increase, without understanding your leverage and options, will disqualify you from receiving anything better for a minimum of 2 years. The truth is, successful PPO fee negotiations have almost nothing to do with asking for fee increases, but rather identifying REAL leverage and understanding how that leverage can impact your success. Reach out to take advantage of PPO Optimization today.

Have more questions about how PPO Optimization and Negotiations can help you and your practice? Schedule a consultation with Kristan Palmer, our Director of Insurance Optimization today by using the following link or fill out the form below and one of our professional staff will reach out to schedule for you.

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“This is the second time we have used this company. Without a negotiation company there is no way I would have gotten higher fees. Last time they paid for themselves in a matter of just a few months. I anticipate the same to be true this time.”

Dr. Waggoner, NV