• Janice Janssen, RDH, CFE

Should you end your PPO contracts?


Inflation is hitting the country hard. We are all feeling the squeeze, whether it be at the gas pump or the grocery store. It is a fact that costs are rising everywhere…except for PPO fee schedules. They are in a lot of cases, going down. How can this be?


The cost of supplies has risen as well as you all know. At Global Team Solutions, we do an annual plan for our clients when they become a client as well as each year that they are with us. Generally, supply budgets are between 4-7% of overall collections for the practice. In the past, we have had new clients that we have had to work with to get that percentage down and were able to do that successfully. For 2021, we had very few that could keep the supply budget in the 4-7% range. Most were between 8.5-12%.


Dental practices across the nation are struggling to find a good team. There was a mass exodus of employees after Covid in all businesses and the dental office is no different. It has been a true struggle to find new team members for some offices. It is even harder to hire new dental professionals when the corporate offices are offering such high wages or sign on bonuses. Don’t get me wrong, I love that teams are making more money. It is simply difficult for the solo practitioners to compete with the increase.


Insurance companies lowering the rate on their accepted fees for the PPOs is simply not working. The excessive adjustments that practices are having to apply to their fees is making it difficult to continue participating with those insurance companies. If you are contemplating ending your PPO contracts, you are not alone. It appears there has been a mass exodus of the PPO plans in 2021 and as we move through 2022. Global Team Solutions has worked with many of our offices to get out of these plans and are seeing huge success.


Ending PPO contracts is scary. Many practices are afraid they are not going to have the patient base required to keep the lights on if they are no longer participating in these plans. It is extremely important to look at your numbers and determine if this is feasible for your practice and develop a plan to go about it. If you are wanting to end contracts with the insurance companies, a slow and steady approach is best. End the contracts one at a time. This helpful for several reasons:


  • You will see some attrition in patients but in our experience, a number of those patients come back and pay a little extra because they value the care given to them in your practice.


  • You will need to send a notification to your patients that the contract is ending and what that will mean for them as a patient. This takes some time for you and your team to compile and get sent out.


  • Your administrative team is going to be fielding questions from the patients on the dental plan that received that letter/email or are coming in for appointments during this time.


If you are looking to end your contracts with any of the PPOs you accept, just remember to be strategic and take it slow. If you need help or have any questions, we are here for you. Please do not hesitate to contact us at info@GTSgurus.com.



 

Janice Janssen, RDH, CFE, Consultant


At age 14, Janice Janssen got an after-school job working for her dentist. Twenty-something years later, she is the co-founder of Global Team Solutions and an expert in practice consulting. Besides hands-on experience, Janice has gained professional recognition for her hard work and commitment to excellence. She is co-author of OMG! Office Management Guide, the “bible” used in GTS training workshops. She is a member of the Academy of Dental Management Consultants (ADMC), and is a Certified Fraud Examiner (CFE), which positions her as an expert in educating dentists to deter fraud and embezzlement in their practice.

Janice can be reached at: janice@gtsgurus.com

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