PPO Negotiations
Thinking of dropping Delta Dental?
Thinking of cutting back on dental PPO participation?
Tired of writing off tens of thousands every month to dental PPOs?
Want to Lose the Discounts and Keep the Patients?
The right “plays” with PPOs can have a substantial impact on your bottom line. No one has more experience with PPO plays than Bill Rossi and his team at Advanced Practice Management. If you are considering joining, dropping, or negotiating with a PPO, call us.
No contracts, no hype, just straightforward advice. We have helped scores of clients increase their collections by tens of thousands per month. Find out the right dental PPO play for you!
Call 952-921-3360 or text 952-228-9486 for your 20-minute consultation. No pressure, no bull; just a chance to find out more.
Negotiations - Decisions - Transitions
Bill Rossi is the country’s leading expert on PPO decisions and transitions. PPO decisions must be made in the context of the practice’s realities. Bill has over 35 years’ experience in advising dental practices. For the past 20 years has helped many dentists successfully cut back on their PPO participation to enhance their bottom line and practice independence.
Shelly Ryan has successfully helped practices increase their bottom line through negotiating insurance reimbursement and leaving networks with minimal patient loss. Her 30 years of experience in dentistry as a registered dental assistant, practice manager, and team coach gives her an edge when working with teams as they navigate through the tangled web of insurance. She analyzes and identifies where your practice is losing money; and when it is time for your practice to get out of PPOs.
Read Bill Rossi’s Profitable Dentist Articles:
Read Bill Rossi’s McGill Advisory Articles:
- How To Increase Profits By Playing It Smart With Delta
- 3 Steps To Increase Profits By Reducing PPO Participation
- 4 Steps To Make Profitable PPO Changes For Your Practice
- How You Can Make Practice PPO Decisions Profitably
- Boost Profits By Managing Your PPO Participation
- 5 More Ways To Boost Profits While Dropping Managed Care (PPO) Plans
- 7 Steps To Boost Your Practice Profits While Reducing Managed Care (PPOs)
- Evaluate PPOs When Building Your Practice By Purchase
Read Bill Rossi’s Dental Economics Articles:
Read Bill Rossi’s Collier & Associates Articles:
Fortifying Your Practice Through A PPO Transition- Is Your Practice Primed To Drop One Or More PPOs?
- Three Case Studies Show How Dropping a PPO Plan Increases Profits
- Dropping a Low Paying PPO Plan and Limiting the Damage
- Negotiating PPO Reimbursements
- According to Bill Rossi of Advanced Practice Management, There Seems to be a Law of Diminishing Returns by Adding the Next PPO
- “PPO Transition: Lose the Discounts, Keep the Patients!”
- Balancing PPO Participation
Listen to Bill Rossi’s Podcasts & Interviews:
How a Dentist Can Manage and Exit Being In-Network with a PPO with Bill Rossi – The Art of Dental Finance and Management Podcast
March 11, 2020
Bill Rossi
10 Things You Need to Know About You and PPOs
By Bill Rossi
1. You have more power than you think.
2. Practices with little or no PPO participation generally do get fewer new patients. However, practices deep into PPO participation do not get proportionally more new patients as they take on more and more programs and more discounts.
3. Each practice has to find the “right balance” of PPO participation. When Dentists have complete control over their fees, most of them try to balance the fees so they aren’t too low or too high. In effect, moderating your PPO participation is like setting your fees.
4. Chances are that you are already seeing some patients out-of-network. For every PPO plan, there are providers both in and out of the network in your area. No insurance network, not even Delta, has 100% of providers in a given area.
5. Employers provide Dental insurance to make their employees happy. Of course, they want to save money, but their employees aren’t happy if they can’t see the provider they want to see.
Therefore, most insurance companies do not have “punitive” out-of-network benefits. In fact, for some, the out-of-network benefits are surprisingly good.
6. If you drop a PPO and your staff is properly trained, you will retain the majority of the PPO patients – unless the patients have no out-of-network benefits or very little out-of-network benefits.
7. Whenever dealing with insurance either as in-network or out-of-network providers, it’s important to accentuate the positive,
“The good news is that with your Delta policy, you can go to the Dentist of your choice…”
“We have many patients on this plan and in general things work out quite well.”
8. Some PPO fees can be negotiated. If you haven’t tried, there is a good chance you’ve left money on the table. It costs little to do this and the extra dollars are “free money.”
9. You can’t just leave PPOs without having a strategy. In other words, you must take measures to fortify the practice and build it up in the face of the inevitable patient attrition.
10. If you are collecting less than 80% of your Gross Production, you need to take a serious look at reducing PPO participation. Too often Dentists sign up for a plan too quickly and drop too rashly. There are thousands of dollars and many patients at stake. Make your decisions logically.
Dr. Abby Krienke, Lincoln, NE
“I have started to create a women’s dental group and added an association for dentists in my area. I have been so happy as your client and tell everyone about you. After working with another consulting group in 2017, I can tell you APM has exceeded my expectations.”Dr. Stephen McCuin - Radford, VA
“After a careful analysis, Bill determined we could transition out of a major PPO in my practice. After some thought (and another year of aggravating write offs) I decided to go ahead. We sent the drop notice. The next thing we know, the PPO offered a significant increase in our fee allowances. So we decided to take it. We will collect thousands more as a result. Bill says that the best negotiation tool a Doctor can have is to send a drop notice. If they hadn’t come up nicely, we were ready to act because we knew we would be well prepared.”Lois Y. (Office Manager, Centre Family Dentistry) - Fort Collins, CO
“Bill helped us with the process of leaving the PPO and working together we adapted the approach that suited our practice best. Very helpful advice.”Dr. Bob Boyat
“We worked with Bill Rossi to leave a PPO and it reduced our discounts significantly. We did not have any serious loss of patients and continued to grow through the transition.”Dr. W. Kiesel, Quakertown, PA
“After an analysis by Bill we decided to go ahead and drop Delta Dental. It is quite a leap but with Bill’s coaching and advise we are actually up 20% in production plus, of course, seeing a big increase in collections.”Deborah Parr, office manager, Dr Olan Parr Culpepper Va.
“Have you ever seen the look on a small child’s face when you try to gently take away their security blanket? Eyes widen in horror and their grip tightens even more. I believe most dentists [and office managers – that’s me] feel the same way when first considering going out of network with an insurance company. The blanket is frayed and doesn’t smell so good [write-offs are so big you lose money on every patient], but the loss is too scary to think about…. Or is it? After being in network with one particular insurance company for 12 years and experiencing exactly ONE increase in what they paid us [not on all codes, just some fillings for about $.25 per filling – yep, that’s 25 CENTS] we were looking for a way out. I hated watching my highly trained and excellent practitioner husband working harder and harder for less and less. The smartest move we made in our bid for independence was to contact Bill Rossi of Advanced Practice Management. We sent reports, details about our practice, investigated which employers used which insurances, and then more reports. The FBI could take lessons from Bill! But because of his thoroughness in finding out about our practice, he could tell us that he believed we would not only survive but do very well out of network with that company. Then he visited our office and walked our team through what to do, say, expect. Had we attempted it on our own, we would have made some serious mistakes in our approach to patients. Seven months later I can honestly say we are doing at least fine. The vast majority of our patients have stayed with the practice and it turns out for most plans the insurance company pays really close to our fees. We are so glad we made this choice. Letting go of the in-network security blanket isn’t easy, but Bill will get you through it just fine.”
Dr Lee Fletcher, Greenville S.C
“Bill analyzed my specific situation and showed me how to negotiate for my practice from a position of strength. He provided me with the knowledge and advice that I needed to manage my insurance relationships in a strategic manner for the long term success of my practice. Bill is a passionate advocate for the solo practitioner and has the knowledge to help you manage your practice in today’s complex environment.”Lis Bradley - Lisbeth S Bradley DDS
“I first met Bill Rossi when I read an amazing article he wrote for the McGill Hill newsletter. Even tho I am not in his part of the country I was impressed and Bill agreed to talk with me. We ended up working with Bill on several things, one being transitioning out of a PPO which is always a very scary thing to do. He held our hands and walked us through the process. The results have been impressive! Whenever I have a question or need a solution to a problem Bill and his team are always very responsive and have excellent suggestions for me and help with how to implement.I depend on and trust his expertise.”
Dr Ross Hock, Canton, Michigan
“Bill and his team have been a great resource for me in the advancement of my dental practice. He has consistently given me great advice on topics ranging from questions about staffing issues, integration of a new associate as well as the acquisition and integration of an outside dental practice into my own. Bill also helped me through a major PPO transition. I would recommend him without hesitation.” Drs. Potach and Mitchell
“Shelly helped our office go out of network with a major PPO and become a fee for service practice. There were difficult aspects involved in making this decision and she provided guidance that was well thought out. It feels good to come to work every day and get paid for what what we do and our patients feel the same way! We wish we would have done this years ago.”
Dr. David Parks, Clinton, MS
“Bill’s advice helped us through two PPO transitions. Like most Dentists would be, I was a little nervous about doing this but it has worked out well. Collections are up by thousands per month.” Ruth Lackey, Office Manager - Radford, VA
“Bill’s advice was very helpful.” Dr. Jordan Humbert of Fort Collins, Colorado
“Bill analyzed our situation and helped us through a major PPO transition. It has added thousands of dollars per month to our collections and our patient flow is as good as ever.””Dr. Kirby Johnson - Spicer MN
“Shelly and Bill have given us coaching and advice that has helped us have a strong growing practice. Their guidance was also very helpful in our decision to cut back on PPO participation last year and increase our collections by over $10,000 per month.”Roy Krengel DDS, Bloomington, MN
“I was dealing with a PPO that said they wouldn’t negotiate and wouldn’t pay me more. With the information and advise Bill gave me I was able to successful pushthem and received a significant increase in reimbursement allowances.”
Andrew Olsson DDS, Hood River Oregon
“Bill helped tremendously when I was struggling to find the right path for my practice. I am about 6 months in since our first conversations and we have made several big changes in the practice for the better. The experience Bill brings to the table helped me be confident in making these decisions. We have reduced our PPO participation considerably and will be adding an associate soon. Thanks Bill and APM!” Dr William Poole, Leola, Pa
“Bill, will be faxing (an unnamed here ppo) new fee proposal to you today. I got firm with them on Monday and they came up quite a bit. Thanks for the advice!” Dr. Jim Tomhave, Cloquet, MN
“Bill helped us significantly increase our insurance allowances. His advice at a key juncture of practice transition has been very helpful.” Dr. Joseph Gendler, Hopkins, MN
“Bill Rossi’s advise on insurance-related topics has worked very well. Our work with him has added many 1000s of dollars to our bottom line.” Dr. Jeffrey Chandler, DDS Dentist - Oral/Maxillofacial Surgery, Elmhurst, IL
“Bill’s advice really helped me organize my approach to negotiating with and making decisions about PPO’s.” Matthew Colaizy DDS
“Shelly provided a detailed analysis of our insurance participation and found “hidden” ways we were losing money. I would not have had the time nor the staff to dig through this complicated process. Because of her efforts, our collections increased by 3%-4%. I am able to work less and collect the same.”
Call Bill Rossi at 952-921-3360 today to schedule your free, no obligation 20-minute consultation to find out more!
