Dental Practices Going Out-of-Network – the Difference Among Insurers

Shelley DeGroff, Founder of PPO Advisors More than ever, dental practices are exploring the idea of dropping all their insurance contracts and going 100% fee-for-service. Given the relentless effort by many insurers to lower reimbursements to providers, the appeal of totally eliminating insurance-pay from your practice is not surprising.  But going entirely fee-for-service isn’t easy ...

Filed Under: PPO Advisors

Can Your Practice Drop Delta Dental?

Shelley DeGroff, Founder of PPO Advisors A big topic currently trending among providers is whether or not to drop Delta Dental. As everyone should know by now, Delta is phasing out and replacing its Premier Network with a low cost PPO network, which slashes reimbursements by 15-25%. Many dentists are unable to provide the level ...

Filed Under: PPO Advisors

How Practice Owners Can Get Better Reimbursements from MetLife

By Shelley DeGroff, Founder of PPO Advisors The dental insurance landscape is constantly evolving. To keep up, practice owners need to be strategic about how they contract with insurers. There’s a tendency for dentists to adopt the “strategy” of simply trying to be in-network for everybody, but that’s neither feasible, nor financially sustainable. Instead, dentists ...

Filed Under: PPO Advisors

Cigna Increases Pressure on Dental Providers to Lower Fee Schedule

By Shelley DeGroff, Founder of PPO Advisors If you’re feeling squeezed by your PPOs – you’re not imagining it and you’re not alone. Even as dental providers are struggling with the post-COVID labor shortage and high inflation rate, insurance companies are taking legally and ethically questionable actions in a bid to pressure providers into accepting lower ...

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Insurance Free or Friendly – What’s the Best Strategy for Your Dental Practice?

By Shelley DeGroff, Founder of PPO Advisors A growing number of dental practice owners are asking if it’s worth it to join PPOs versus going insurance free. Given recent actions by insurers to pressure providers into lowering fee schedules, the question is understandable. Unfortunately, the answer isn’t going to be the same for everyone. While some ...

Filed Under: PPO Advisors

Top 5 Reasons to Outsource Credentialing

By Shelley DeGroff, Founder of PPO Advisors To participate in various insurance networks, dental providers must be credentialed, a process that is cumbersome and requires copious paperwork, including proof of education, residency, training, work history, licenses and if applicable, specialty certificates and malpractice history. To stay in network, providers must repeat the process every 2-3 years, ...

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Trust but Verify – Practice Owners Should Make Sure Promised Fee Schedule Increases are Real

By Shelley DeGroff, Founder of PPO Advisors In dealing with insurance companies, I believe in the trust-but-verify approach. I was reminded of this recently when we were onboarding some new clients. They shared with me similar stories about how, before coming to PPO Advisors, they’d worked with competitors who told them they’d negotiated higher fee schedules ...

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All About CDT Codes and How It Impacts Reimbursements

By Shelley DeGroff, Founder of PPO Advisors As a dental provider, the more you understand about how your practice generates revenue, the better. With that in mind, let’s take a short walk into the weeds by talking about Current Dental Terminology (CDT) code and how it can impact insurance reimbursements. Purpose of the CDT Code A ...

Filed Under: PPO Advisors

Accidental Insurance Fraud? It’s Easier Than You Think. Another Reason to Know What’s in Your PPO Contract

By Shelley DeGroff, Founder of PPO Advisors It’s easier than ever for a well-intentioned dental practice owner to inadvertently commit insurance fraud. To avoid the problem, practice owners must know what’s in their PPO contract, or risk the repercussions. Too many practice owners these days don’t know what’s in their PPO contract. The complexity of ...

Filed Under: PPO Advisors

2022 New Year’s Resolution for Dentists – Pay Attention to Your PPO Contract to Avoid Losing Revenue

By Shelley DeGroff, Founder of PPO Advisors For dental practice owners, one of the best New Year resolutions you can make is to pay close attention to your PPO contract. Now more than ever, insurers are looking for ways to reduce reimbursements to providers. Find out what you should do now to avoid lower revenue ...

Filed Under: PPO Advisors