Why Are My Providers on Different Fee Schedules?

In 2010, preferred provider organizations (PPOs) made up 74% of the dental benefit market. Numerous dental practices are contracted with more than one PPO. Sorting through all of the contracts and fee schedules can be confusing for your billing professionals and your bottom line. Thankfully, there are ways to streamline your carrier contracts and make the entire process easier.

Understanding Fee Schedules

As a PPO office, you first need to understand that you will not collect your full fee for any given procedure. Instead, you will be reimbursed in accordance with your fee schedule. You should be reviewing your fees on a regular basis and adjusting based on the market around you. When it’s time to recredential with every provider you partner with, you should also take a close look at how much the provider is offering you. If they are unwilling to negotiate, are the reimbursements you’re receiving and the patients you’ve attracted worth signing again?

The Benefits of Streamlining Carrier Contracts

Many practices do a poor job of tracking contracts and fee schedules due to being contracted with so many entities. If you sign a contract with a third party with access to numerous markets, you should keep that in mind when condensing things. Streamlining your contracts and getting a consistent fee schedule across PPOs will make things easier on your billing department and your budget.

Utilize a PPO Negotiation Service

Fee negotiation is complex and can take some time. Unless you have one provider and only a few codes you are interested in negotiating for, it’s a great idea to work with a professional service like APEX Reimbursement Specialists. We can help you determine which fees are most important to your practice’s bottom line and negotiate with PPOs on your behalf to get the most out of your fee schedule. We can also take care of renegotiating when you recredential with dental practices. By staying on top of your fee schedules and contracts, it will be easier to balance your fees with providing the best level of care to your patients. 

Partner with APEX Reimbursement Specialists

The experts at APEX Reimbursement Specialists can help you to explore the best options for your continued growth and sustained success. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.