PPO Solutions

PPO Solutions

Startup Practices

The best time to negotiate PPO contracts is before you credential with the insurance company.
Starting a new dental practice can be overwhelming to say the least! Every second you and your dental team spend navigating PPOs isn’t time well spent. Let us manage your credentialing process including helping you set your master fees based on your demographic, negotiate the best possible PPO fee schedules and turn PPOs into profit for you! In addition, we work with you and your team to manage the dreaded ‘out of network’ period.

PPO Advisors can suggest the best insurance companies for your dental practice. Thanks to our years of dental industry knowledge, this valuable information can help you save time and make more money in the long run! Ask a member of our team if we have demographic analysis that relates to your area.

Startup dental practices are shelling out thousands of dollars on equipment, fit-out costs and more. Our savvy team will start by collecting information required to commence your credentialing and negotiation process with the right insurance providers. We then assess, research and present your options in a clear and easy to follow overview that shows how much our services can grow your profits for PPO success. Once we have the greenlight, we guide you through every step to turn your PPOs into profit.

SOLUTION: PPO Advisors makes sure you are entering into contracts that continue vs. contracts that will hold you back without specific terms or renegotiation options to name a few. Understanding what you are signing and what to look for are imperative. Having PPO Advisors by your side ensures your licensing is updated and all information is mapped back to make the credentialing process as smooth as possible.

SOLUTION: PPO Advisors has helped hundreds of dental practices set their fee schedules thanks to an independent zip code analysis. Their knowledge and experience will provide you with the insights you need to set the best master fees for your back pocket.

Dental Practice Startup Services Offered:
  1. Analyze UCR/Zip codes to set master fees.
  2. Custom negotiations with insurance companies for highest fees.
  3. Determining the best ways to be contracted.
  4. Complete the credentialing process with insurance companies on your behalf.
  5. Stacking contracts correctly to ensure long-term success.
  6. PPO Network Playbook.
  7. Insurance Team Training.
  8. Ongoing Professional Support for 12 months.
  9. Exclusive access to Credentialing Access Point (CAP).   Contact Us To Learn More
 

Acquisitions

TAKE THE GUESSWORK OUT OF YOUR PPOs

Acquisitions bring countless positives and their share of challenges! One of these challenges is navigating intricacies of the new entity’s PPO contracts. As you may know (or are learning), the acquisitions process is extremely detailed and managing the seller and buyers PPOs are a necessary but time-consuming task. Thankfully, PPO Advisors have helped hundreds of dental practice buyers to efficiently renegotiate their PPOs to achieve better terms and improved fee schedules. Lucky for you, we offer a buyer/seller analysis. Save your precious time and contact us today!

PPO Advisors knows how to navigate through insurance roadblocks to ensure the new buyer is on the best networks and fee schedules available which often results in a 20-30% increase of PPO reimbursements.

We offer two levels of support depending on your needs: Change of Ownership and Complete Acquisition Program. To begin, simply contact to decide which service suits your needs.

SOLUTION: In an acquisition, a new entity is formed and existing contracts setup with the Seller must be removed. Failing to do so can result in new contracts not being accepted. Your new tax ID number and credentialing creates an opportunity for PPO Advisors to negotiate on your behalf to obtain better fee schedule rates. The results are typically better terms, information clearly mapped and licensing updates. You’ll receive an optimized fee agreement, and we will clearly outline all details so that you know exactly what you are signing.

SOLUTION: In an acquisition, the timeframe given to be setup as a new provider before taking ownership is typically 4 weeks, but this process takes about 7 months; 4 weeks for PPO Advisors to complete negotiations and applications and then around 6 months for the networks to review and accept. This is a common problem that our acquisition clients face, and we work with them on how to be an ‘out of network provider’ during this transition period. We also work with your team on how to communicate this to your patients to mitigate lost clients and ensure their continuity of care.

Acquisitions Services Offered:
services provided Contact Us To Learn More

Established Practices

The best time to negotiate PPO contracts is before you re-credential with the insurance company.
Most established dental practices think of their PPOs as a big headache that are eroding their profits and most of the time, they are right! Thanks to years of experience, PPO Advisors knows how to play the game; we are often able to get new contracts that provide you with better fee schedules and improved long-term benefits. That’s right, you are not stuck with your existing PPO contracts. PPO Advisors can find ways to optimize your PPO fees and increase your bottom line. PPO Advisors can provide your dental practice a substantial ROI regardless of your size. Our clients range from single providers to large multi-provider established dental practices.

Our established dental practice clients receive the biggest ROI for our services. Typically, these clients receive 5x their investment! The best part is, thanks to our free PPO analysis, they have nothing to lose and everything to gain!

Established dental practices simply need to contact us for a free PPO analysis. Our experienced team will collect and review their existing fee schedules, analyze areas for improvements, and research the financial benefits we can make. From there, we present the information back to the dental practice and answer any questions they may have. Once the upside is realized, we commence our engagement and work on your behalf.

SOLUTION: PPO Advisors enjoys working with established dental practices to negotiate on their behalf. We remove or rearrange your existing contracts to allow for new contracts that are financially beneficial. In addition, we update all licensing, map the information and provide you with optimized fee schedules that are crystal clear about terms, renegotiations, long term impacts and more.

SOLUTION: The rule of thumb is that you should increase your master fees annually by 1-3%. When you work with PPO Advisors, we address this topic for you ensure that a new fee schedule is included in our negotiations. PPO Advisors knows how and when to increase your master fees which can have a massive impact on your profit.

Established Practice Services Offered:
  1. Free ROI analysis, this includes evaluating current PPO history and master fees.
  2. Complete the credentialing process with insurance companies on your behalf.
  3. Custom negotiations for higher fees.
  4. Determining the best ways to be contracted.
  5. Completing the credentialing process with insurance companies on your behalf.
  6. Stack contracts correctly to ensure long-term success.
  7. PPO Network Playbook.
  8. Insurance Team Training.
  9. Ongoing Professional Support for 12 months.
  10. Exclusive access to Credentialing Access Point (CAP). START FREE PPO ANALYSIS

Multi-Location Practices

Multi-location dental practices add multiple complications to mapping, licensing and negotiating with PPO providers.

Rest assured, PPO Advisors are experts at supporting privately owned, multi-location established practices with their custom negotiations, credentialing, and more. Your experienced PPO Advisors team works directly with your team to provide personalized and efficient service that leverages your size for big benefits.

Not all PPO companies are capable or offer to work with multi-location dental practices. PPO Advisors has no corporate backing and therefore, no hidden agenda. We work directly with your team to provide personalized service and the results are always impressive!

Just because you represent multiple dental practices, does not mean you should pay until we can prove our ROI. Yes, providing our free PPO analysis for a large group does require more work on our part but we believe you shouldn’t pay for services before you know how they will impact your bottom line. You will receive a dedicated
Project Manager to collect and review all existing fee schedules. Your team will then receive a clear analysis that shows the financial benefit and ROI that PPO Advisors provides. If you choose to go ahead, we will help you achieve thousands in increased annual revenue.

SOLUTION: Additional locations can make the mapping, licensing and negotiating process more complicated. PPO Advisors manages all of these details and more. We assess all existing contracts and work to remove or rearrange them for your benefit. We enter into new negotiations on your behalf and leverage your size to get you the best possible outcomes.

SOLUTION: Multi-location dental practices often struggle to have all providers participating with the same PPOs. In addition, some contracts have strict limitations about changing or renegotiating. PPO Advisors has worked with several multi-location dental practices and can eliminate how multiple providers are credentialed due to their various setups. Although complex, the financial benefits of streamlining are certainly worth it.

Multi-Location Practice Services Offered:
  1. Free ROI analysis, this includes evaluating current PPO history and master fees.
  2. Complete the credentialing process with insurance companies on your behalf.
  3. Custom negotiations for higher fees.
  4. Determining the best ways to be contracted.
  5. Completing the credentialing process with insurance companies on your behalf.
  6. Stack contracts correctly to ensure long-term success.
  7. PPO Network Playbook.
  8. Insurance Team Training.
  9. Ongoing Professional Support for 12 months.
  10. Exclusive access to Credentialing Access Point (CAP). CONTACT US TO LEARN MORE

Master Fee Analysis

Most dental practices are reluctant to raise fees or understand how their fee levels compare to their local competitors. PPO Advisors includes UCR also known as master fee or zip code analysis in our negotiations with your providers. The results are increased revenue for the same amount of patients and procedures. Let PPO Advisors provide a detailed analysis of your master fee schedule to show how you compare with other providers in your area. We will also make suggestions and provide you with guidance to maximize your profits. Why work harder when you can work smarter? Contact PPO Advisors to start your master fee analysis today.

Did you know?

Analyzing and updating your UCR/master fee schedule typically equates to a 5% increase in your fee for service revenue.

Contact Us To Learn More

Credentialing Access Point (CAP)

The credentialing process is often compared to a tooth extraction – very painful! PPO Advisors has completed over 12,000 credentialing applications and hard to believe, but we love what we do. At PPO Advisors, we help dental providers wherever they are at in the process. From credentialing to re-credentialing, our Credentialing Access Point (CAP) can help manage the process for you and provide better contracts and fee schedules with all information mapped clearly and efficiently.

Most dentists do not understand what they are signing. This often means decreased profits, reduces your ability to negotiate your fees in the future and more. The team at PPO Advisors is well versed in the details of your contracts and will take the time to clearly articulate what you are signing. Turning PPOs into profits is what we do for our clients!

Credentialing is a process that each provider (aka dentist) needs to complete to be eligible for participation with insurance companies in various networks. The process includes completing detailed paperwork and proof of your education, residency, training, work history, licenses and if applicable, specialty certificates and malpractice history. Each provider is credentialed and then re-credentialed every 2-3 years depending on the contract. After the initial credentialing, providers need to be re-credentialed which includes re-verifying licenses, malpractice history and more. Missing the deadline for re-credentialing can have serious revenue impacts. Providers often choose to have their credentialing and re-credentialing managed by PPO Advisors.

About Credentialing Access Point (CAP)

Imagine an efficient tool that can manage all the moving pieces of your licenses, fee schedules, re-credentialing and more. Credentialing Access Point (CAP) is that tool! PPO Advisors created CAP to help the dental industry streamline their credentialing and re-credentialing requirements.

Did you know?

*PPO Advisor’s current clients receive an annual Ultimate Access at no cost additional cost!

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Service Essential Access Ultimate Access*
Licenses x x
Fee schedules x x
Re-credentialing dates x x
Manages entire dental team x x
Multiple locations x x
Deadline reminders x x
CAP tool support x x
Obtains the re-credentialing applications and completes them on your behalf x

Did you know?

For an additional fee, your PPO Advisors team can help rectify a specific insurance claim and/or credentialing issues. Let us manage the headache!

Enroll in PPO Advisors Credentialing Access Point (CAP)
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