At PPO Advisors, we offer a risk-free PPO analysis to help dental practices understand how their insurance contracts are impacting their business. In this blog post, Shelley DeGroff, CEO of PPO Advisors, explains what you can expect from your risk-free PPO analysis and how it can help improve your practice’s profitability.
What Is a PPO Analysis?
A risk-free PPO analysis is a detailed look at how your practice works with PPO insurance companies. Our team will review your current PPO contracts, evaluate how they affect your profits, and identify areas where you could improve. This process is designed to help you make smart decisions about your PPO contracts to increase your profits and avoid potential pitfalls.
What to Expect During Your Risk-Free PPO Analysis:
1. Uncover Your PPO Participation:
We will start by analyzing which PPOs you are contracted with and how those contracts affect your practice. This will give us a clear picture of how much you are relying on different PPOs and which ones are the most profitable.
2. Impact on Your Most Used Codes and Production:
We will examine the specific dental codes you use the most and see how your current PPO contracts affect the fees you receive. This is important to understand where you might be losing money and how to improve your profits.
3. Understanding Network Sharing:
Many PPOs share their networks with other insurance companies. We will review how these shared networks impact your practice. You may be getting paid less than expected due to hidden network-sharing agreements.
4. Predicting the Impact of Fee Changes Over 12 Months:
We will calculate how changes to your PPO contracts or fees will affect your production over the next year. This gives you a clear view of how much more money your practice can make by making the right changes.
5. Discovering Hidden Opportunities for Higher Fees:
Our analysis may uncover opportunities for higher fees you didn’t know about. These hidden increases could help your practice make more money without changing much else.
6. Identifying Hidden Pitfalls in Network Sharing:
We’ll also identify any hidden problems caused by network sharing. Sometimes, shared agreements can lower your fees without you realizing it, and we will help you understand and fix these issues.
7. Negotiations:
After our analysis, we will help you negotiate better contracts with your PPO insurance companies to maximize your profits. This is where we use our expertise in dental PPO negotiation to help your practice succeed.
The Challenges (Limitations):
1. Getting Your Current Fee Schedules:
In some cases, we might be unable to access your current fee schedules directly from the networks. We may need your help in gathering some of these documents from your insurance providers.
2. Not All Contracts Can Be Negotiated:
Unfortunately, we can’t negotiate with all PPO contracts due to certain limitations, such as the contract terms or the timeline. In some cases, we may need to handle negotiations in stages to cover all your PPOs.
3. Highest Increases and Options:
The analysis will map out how to achieve the highest possible increase in your collections. Although this may not be the office’s main objective, it will facilitate the conversation about the complexity of achieving increases.
4. Timeline:
The full analysis and negotiation process typically takes 6 weeks. We want to ensure a thorough review and the best possible outcome for your practice. Additionally, we are at the mercy of how fast the insurance companies respond.
A risk-free PPO analysis from PPO Advisors can help your dental practice understand how to work better with PPO insurance companies and increase your profits. By uncovering hidden opportunities and addressing potential pitfalls, you can improve your PPO contracts and set your practice up for long-term success. Contact PPO Advisors today to schedule your risk-free PPO analysis and take the first step towards a more profitable PPO strategy.