Pencil And Tools


Q | What do you mean by Free PPO Analysis?

A | PPO Advisors is the only company dedicated to providing a true ROI. We believe that PPOs are risky enough; having to pay for a service before you know if it will benefit you just doesn’t make sense to us.

Q | How much can PPO Advisors help my practice?

A | The national average write-off is 40%. PPO Advisors will help you narrow that margin so you are working smarter, not harder.

Q | What do you need in order to analyze our practice?

A | When analyzing established practices, we take a few reports out of your practice management software. Almost all programs have a report that can be used in our analysis. Through the reports, we are able to determine how each insurance company is impacting the practice and how our negotiations can improve revenues. We provide easy step-by-step instructions so an office member can generate the reports on their own time.

Q | How long does an analysis take?

A | The average turnaround time for an analysis is between 6-8 weeks. PPO Advisors requires all proposals be approved by the insurance’s actuary department to ensure we provide the most accurate ROI.

Q | How do you negotiate fees better than our office can?

A | PPO Advisors works hard to build relationships with the insurance reps at each company. We don’t call customer service and hope to get a rep that can help us, instead, we have direct contacts within the companies. Since we are working together on multiple projects day in and day out, we've successfully built relationships and secured a trusted resource for when practices encounter insurance issues. We understand the parameters the insurance companies are allowed to work within. We also have a good idea what fee schedules exist in most demographics, allowing us to negotiate higher fee schedules you didn’t know existed. We have a strong track record with the insurance companies, they know when a practice is working with us, we will provide accurate information, have the correct paperwork in place, and a solid goal in sight. They know we are not going to waste their time, which ensures a positive ongoing relationship down the road for your dental practice.

Q | Do you negotiate the entire fee schedule?

A | Did you know that in most dental practices ten codes make up 90% of your revenue? PPO Advisors will focus on your top producing codes, and through our analysis, we will determine other key codes and trends in coding that would benefit from negotiations.

Q | How long does it take to get credentialed?

A | The typical turnaround time for credentialing providers who are new to the insurance company is 90-120 days. Providers that have previously been credentialed and need to either add a new location or change their EIN may have credentialing times reduced to 45-60 days. Keep in mind, there are several ways to be credentialed for one insurance company. It’s always best to allow for at least 90 days when making PPO changes or additions.

Q | Do we need to know which insurance companies with which we are in-network?

A | No. With the insurance companies’ ability to lease/share, it is tough for practices to keep track of all their in-network payers. PPO Advisors will do that research for you and confirm participation status with each PPO. Once participation status is confirmed, we will obtain the correct fee schedules from the insurance companies and share those with your practice to ensure you have the most up-to-date fee schedules.

Q | We received a request to recredential a provider. Will this interfere with negotiations?

A | No. Credentialing requests occur about every 24-36 months. It is imperative that you handle recredentialing requests promptly; if ignored you will be dropped from the network and required to do a full credentialing (90-120 days) to get back in. Many recredentialing requests will come from a third party and will require the practice to do them electronically through a website.

Q | We are adding an associate, should we negotiate before we do this?     

A | It is always wise to negotiate contracts before adding a new provider. We can help streamline credentialing to ensure that all providers are contracted the same and receiving the highest possible fees schedules for the practice.