PPO Optimization: How to Increase Your Per-Patient Profit

In order to increase PPO reimbursements, some strategies that dental practices can use include negotiating with the insurance company, increasing their fees, and optimizing their PPO participation.

Chloe Hironaka discuss how understanding your PPO participation and current reimbursements is key to increasing your per patient profit.

She suggests looking at your current UCRs (usual, customary, and reasonable fees) and comparing them to the fees that insurance companies are reimbursing you. If there is a significant difference, it may be worth negotiating with the insurance company to increase your reimbursement rates.

She also mentions that there are different types of PPO agreements, such as a “participating” agreement where you agree to accept a lower reimbursement rate in exchange for more patients, or a “non-participating” agreement where you can bill patients at your own rates but may not get as many patients.She suggests that it’s important to weigh the pros and cons of each type of agreement and determine which one is the best fit for your practice.

Chloe also talks about new advancements in the industry such as using data analytics to help negotiate with insurance companies and the importance of staying up-to-date on PPO plan changes and network participation requirements.

It’s also important for practices to understand their current reimbursement rates and make sure they are accurately billing for the services they provide.

As a reminder, some tactics that practices can consider include negotiating with the insurance company, increasing their fees, and optimizing their PPO participation.

Here are some key highlights from the discussion on strategies for increasing PPO reimbursements:
1. Negotiating with the insurance company
2. Increasing fees
3. Optimizing PPO participation
4. Working with a PPO management company or consultant
5. Understanding current reimbursement rates
6. Reviewing and negotiating contracts
7. Offering in-network discounts
8.Expanding treatment offerings

These strategies can help practices increase their per patient profit and improve their overall financial performance.

At Hayes, we make dental staff training fun by bringing Pizza and Beer (or other drinks) during the training so your team can actually enjoy themselves.

For more assistance contact, your local Hayes representative to help ensure that your staff and practice are compliant with your local Hayes Handpiece representative