Managed Care Participation

Three Case Studies Show How Dropping a PPO Plan Increases Profits

Practice management consultant, Bill Rossi of Advanced Practice Management, has shared some numbers for three practices that he helped guide through dropping the same large national PPO plan.  In each case (one on the East Coast, one in the Midwest and one on the West Coast), the PPO discounted fees about 30% and the PPO […]

If PPOs Reach Out to You to Join Their Network, Their First Offer Won’t be Their Best Offer

The managed care provider is trying to build its provider network in your geographic area, and it considers your practice to be a large and successful one.  Listen to their proposal, but be prepared to reject their first (and even second and third) proposals.  Hold out for a reimbursement schedule that comes close to matching […]

Dropping a Low Paying PPO Plan and Limiting the Damage

In the January 15th Newsletter, we summarized how to best negotiate higher PPO reimbursements based on Bill Rossi’s lecture at our Scottsdale, AZ seminar in late December.  What follows is Bill’s advice for dropping a PPO plan and limiting the fallout.  Dropping a plan is a serious business decision and demands careful consideration.  This is […]

Negotiating PPO Reimbursements

In case you weren’t able to attend our recent Scottsdale, AZ seminar, here are some recommendations from practice management consultant, Bill Rossi.  There can be a lot of money to be made if you handle this correctly: Do your homework. To get a sense of your fee reductions, prepare a spreadsheet with vertical columns going […]

Will Offering a Discount Coupon, or a Senior Discount, or a 5% Savings for Paying in Cash For an Initial Exam be Considered Working with Two Fee Schedules and a Violation of a Dental Insurance Contract for a Participating Dentist?

If it is, then you will have a lot of company.  Many practices are offering these discounts.  Special deals have been around for years, and we have yet to see a dentist get into trouble with Delta or any other insurance company for offering special deals – even during extensive insurance audits.  This is the […]

Recent Advanced Practice Management Survey Shows that PPO Participation Tops Dentists’ Lists of Concerns

One interesting finding was that fewer than 5% of survey respondents dropped a plan over the past year or plan to drop one in the coming year.  Another was that PPO participation is higher than it needs to be, with many practices accepting plans paying less than 75% of their standard fees.

“Accounts Receivable Management”

by: Gary Henschen Accounts receivable management begins with a well-trained staff member(s) who has their boss’s endorsement to make firm financial arrangements at the time treatment is accepted.  This helps prevent accounts from going delinquent or hiring additional personnel or an agency to collect on delinquent accounts. The most common question I receive from dental […]

According to Bill Rossi of Advanced Practice Management, There Seems to be a Law of Diminishing Returns by Adding the Next PPO Plan

Practices with little or no insurance participation generally see fewer new patients than practices with more participation.  However, is there a point where there are diminishing returns with increased PPO participation?  Anecdotally, he (and we) have noticed that practices that participate in almost every PPO available don’t see a proportionally greater number of new patients, […]

Dropping a Low Reimbursing PPO Plan

Based on informal surveys taken of doctors at our seminars, we are heartened to see that those who stop participating with the stingiest plans end up retaining the majority of the patients, collecting their full fee, and being happier in practice. If you continue to participate in-network, try building a good relationship with the provider […]

Delta Dental Shenanigans Require a Careful Analysis Before Hiring a New Associate and a Thorough Understanding of your Delta Contract

If you’re a Premier provider, understand that in many states now, any new associate who joins your practice who was not credentialed with Delta before August 2014 cannot be a Premier provider.  He or she must sign up as a PPO provider.  This requires careful analysis, because once the PPO plan enters the practice, this […]