To PPO or Not to PPO?

Many dental practices rely on PPOs to keep patient chairs full and revenue high. However, your affiliation with PPOs doesn’t need to come at the expense of your practice growth. It’s time to ask yourself the age-old question—to PPO or not to PPO?

You Don’t Need to Be in Every Network

For new dentists and practices looking to grow rapidly, it’s tempting to enroll in as many networks as possible to have access to the highest number of patients. However, you should first evaluate the fee structure and network parameters before applying. Loss leaders do not benefit most private dental practices unless a single PPO can provide you with hundreds of active patients. While reimbursement rates can always be negotiated, you should focus on first signing up with the networks that will do the most work for your practice.

But Being in a Network Can Help

In 2016, the American Dental Association found that over 73% of dental patients use insurance or Medicaid. Over 92% of dentists are contracted with at least one PPO as an in-network practice. Even if you are frustrated with one or two of the networks you are currently participating in, it’s a good idea to keep at least one around if you want to keep pace with your competitors.

Invest in Marketing and Your Practice First

If you are a new dentist or an old practice looking for new patients, you might want to try investing in new marketing before you potentially cut into profits by enrolling with a PPO. The more that you can invest into aggressive local marketing efforts, the more that you could potentially make from patients. Explaining the benefits of choosing your practice through patient marketing may reap you more benefits than the patient incentive of being in-network.

Before You Enroll with a New Network: Questions to Ask

  • Should we enroll in new networks to raise patient numbers and revenue?
  • Are we losing patients due to being out of network? What PPO plans are patients requesting to utilize the most?
  • Is our practice out of network with a plan that has a major employer in the area?
  • Are our patients who are out-of-network able to pay for our services?

PPO Reimbursement Negotiation from APEX

APEX Reimbursement Specialists can handle the credentialing process and negotiate with PPOs on your behalf. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.