November 2025 ISSUE
By Bill Rossi*
Doctors that aren’t as busy as they wish, often make a tragic mistake. They sign up to go in-network with a number of PPOs in order to boost their new patient flow and related practice volume. After a while, reality hits home. While their production has increased, their PPO write-offs have skyrocketed and their profits are declining. In reality, their initial misstep has resulted in them working harder to make less money.
Understanding how to correct the problem is not that difficult. You merely need to charge out all production at full fees and then make an adjustment (write-off) based on the fee allowed under the PPO plan. Tracking these adjustments on monthly and annual basis allows you to easily determine how much production (and profit) you’re writing off.
While many doctors track this information and can easily determine the extent of their problem, correcting it is much more difficult. They’re afraid that by dropping (going out of network) one or more PPO plans will result in a tremendous loss of patients, and a decline in profitability. The reality is often quite different. With a proper gameplan and staff training, you can retain most of the patients even after going out of network.
Bill Rossi* has assisted doctors with more PPO drops, (or “exorcisms” as he calls them), than anyone else nationally. His firm, Advanced Practice Management, handles a number of smaller scale PPO drops, as well as cleaning up umbrellas. However, Delta Dental drops are the biggest play, since it has the biggest risks and rewards.
Recently, he met with one of our clients, a high-performing ($2,000,000 annual collections) solo general practice in the Midwest. While the owner was in network with only one PPO (Delta), it was significant. Approximately 42% of the practice’s production came from Delta patients. However, the annual PPO writes-offs of more than $250,000 forced the doctor to consider going out of network with Delta.
After a thorough analysis and soul searching, the doctor decided to transition (go out of network) with Delta in September of 2024. Rossi’s team worked with this doctor, helping train the staff to properly communicate the decision in order to reduce patient loss. His goal was simple – keep the patients and lose the discounts!
One year later, Rossi reviewed the results with us. After going out of network with Delta, production dropped around 2% over the next twelve months, or around $48,000 annually. However, collections increased by almost $17,000 a month, or more than $200,000 a year, since patients were paying the full fee. Better yet, 100% of those added collections went to the bottom line as increased profit! Furthermore, the practice’s collection rate (collections divided by net production) surged from 87% to 96% over the year, even though the doctor’s clinical days and hours worked actually dropped.
If you’re interested in earning more while working less in 2026, now’s the time to analyze your PPO production, adjustments, and collections. If your practice is operating at 95% or more of optimal capacity, defined as being as busy as you want to be, you’re a good candidate for a profit-boosting PPO exorcism.
*For more information on his firm’s practice management services, including strategically and safely dropping PPOs, contact Rossi at brossi.apm@gmail.com or by phone at 952-921-3360.