This chapter emphasizes the critical need for dentists to negotiate insurance allowables within PPO environments to maximize their practice's financial health. It outlines strategies for effective negotiation with major providers, highlights the importance of understanding procedure costs, and discusses how to prepare patients for potential changes in insurance networks. Additionally, it provides actionable advice on organization and communication to enhance negotiation outcomes and sustain profitability.
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Unlocking better insurance reimbursements isn’t about luck—it’s about knowing the rules of the PPO game and playing to win!
In this episode, we sit down with Dana Moss, an expert in PPO insurance allowables, to reveal the negotiation secrets that empowered her (and countless dental practices) to dramatically boost revenue. Dana’s hands-on approach, honed over two decades of successfully managing and negotiating on behalf of dental offices, proves that with the right tactics, dentists can finally take control of their income streams.
From demystifying negotiation timelines with major players like Delta Dental and MetLife, to understanding how to use percentile data and savvy step-by-step processes, Dana guides you through the strategies that work in today’s PPO landscape. This conversation is packed with advice—covering fee balancing, building genuine relationships with insurance reps, and handling stalled negotiations—along with practical guidance on how even small practices can take a DIY approach. If maximizing PPO revenue and navigating insurance with confidence are your goals, this episode is your roadmap!
What You'll Learn in This Episode:
Why negotiating PPO allowables is non-negotiable for increased practice revenue
How to strategically time and approach negotiations with major PPOs
Proven tactics for fee balancing and setting competitive office fees
How percentile data can inform smarter out-of-network UCR fees
Step-by-step processes for successful, organized negotiation
Handling pushback: what to do when insurance companies refuse
The right (and wrong) way to leverage your network participation
Building strong relationships with insurance reps for better outcomes
DIY negotiation resources and tips for practices of every size
Key principles for long-term, profitable PPO participation
Listen now and discover how you can take charge of your practice’s PPO negotiations for lasting financial growth.
Sponsors:
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p.s. Some links are affiliate links, which means that if you choose to make a purchase, I will earn a commission. This commission comes at no additional cost to you. Please understand that we have experience with these products/companies, and I recommend them because they are helpful and useful, not because of the small commissions we make if you decide to buy something. Please do not spend any money unless you feel you need them or that they will help you with your goals.
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