As the busy summer season ends, many dental offices start thinking about their goals for the following year. One important task should be reviewing your PPO contracts and UCR (Usual, Customary, and Reasonable) fees. In this blog post, Shelley DeGroff, CEO of PPO Advisors, shares simple steps to help dental practices negotiate higher fees with PPO insurance companies and improve profitability.
Can You Still Negotiate with PPOs?
We often ask, “Can you still negotiate higher fees with PPOs?” The answer is yes! However successful dental PPO negotiation involves some preparation and strategy.
Here’s how to get started:
Step 1: Understand Your PPOs’ Impact:
Review how each PPO affects your practice. Ask yourself:
✅ How many patients from each network do we serve?
✅ How much does it cost (write-off) to see patience from each network?
✅ How much am I writing off with them?
Understanding this data helps you know what changes to request when negotiating with network representatives. It’s essential to ask the right questions to get the best deal for your practice.
Step 2: Review and Increase Your UCR
Your UCR (Usual, Customary, and Reasonable) fee is what you usually charge for dental services. Increasing your UCR by at least 3% every year is recommended. Why? Because if you don’t increase your fees, insurance companies have no reason to raise their reimbursement rates. Another tip is to submit your full UCR fee on claims—not the PPO fee. This encourages PPO insurance companies to keep your fees competitive.
Step 3: Analyze Your Practice’s Demographics.
Take a look at the demographics in your area. Are there new employer groups or businesses nearby? You want to ensure you accept the right PPOs that offer the best fees for your practice. Sometimes, choosing different PPOs or renegotiating existing contracts can significantly affect your profits.
Important Note on Fee Sharing:
You may hear about other dental offices’ fees, but remember that fee schedule sharing is not allowed. PPO Advisors will never share fee information from or with other clients because each provider’s negotiation depends on their location and situation. Things like the number of providers and the rate at which those providers agreed to first in your area and the growth of local employer groups can affect your negotiation.
Maximizing Your Profits with PPO Solutions
Negotiating higher fees with PPO insurance companies and increasing your UCR are two essential ways to boost your practice’s profits yearly. These strategies ensure that your practice stays profitable and competitive. If you’re unsure where to start, PPO Advisors offers free PPO consulting and analysis to help you understand the best options for your practice.
By reviewing your PPO contracts, analyzing your fees, and negotiating with insurance companies, you can improve your practice’s financial health. PPO Advisors is here to guide you through the process, helping you get the most from your PPO contracts. Contact PPO Advisors today for a free PPO analysis and start boosting your profits!