698: 2024 Trends in PPOs - Shelley DeGroff

Have you ever wondered about PPOs or struggled to understand them? Kirk welcomes Shelley DeGroff to shed some light on this complex relationship between dental practices and insurance. Shelley is the founder and CEO of PPO Advisors, a firm that helps dental practices turn their PPOs into profit. She talks about the trends of 2024, emphasizing the importance of understanding the percentage of write-offs and the need to evaluate fee schedules. The conversation concludes by encouraging dentists to play the insurance game with confidence and seek expert help when navigating the complexities of PPOs.

Learn More About Shelley and PPO Advisors 

• Follow PPO Advisors on Facebook: https://www.facebook.com/PPOAdvisorsLLC 
• Learn more about PPO Advisors: https://ppoadvisors.com

More Helpful Links for a Better Practice & A Better Life:

• Subscribe to the Best Practices Show: https://the-best-practices-show.captivate.fm/listen
• Join the Best Practices Association: https://www.actdental.com/bpa
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt/
• See the ACT Dental/BPA Live Event Schedule: https://www.actdental.com/event/
• Get the Best Practices Magazine for free: https://www.actdental.com/magazine/
• Please leave us a review on the podcast:  https://podcasts.apple.com/us/podcast/the-best-practices-show-with-kirk-behrendt/id1223838218

Main Takeaways: 

• Evaluate fee schedules and understand write-off percentages to ensure proper reimbursement.
• Regularly audit EOBs to identify discrepancies in fee schedules and reimbursement.
• Proper credentialing and negotiating contracts are crucial for setting favorable rates.
• Be aware of network shares and changes and regularly assess your PPO mix.

Snippets:

01:14 Introduction to Shelly DeGroff and PPO Advisors

06:20 Write-off Percentages

08:13 PPOs and Fiscal Years

09:41 Fee Increases and Negotiations

10:41 Evaluating Fee Increases

11:39 Master Fee Schedule

13:01 Credentialing and Setting Rates

16:23 Understanding Umbrellas and TPAs

20:43 The Importance of Credentialing

22:01 Negotiating Contracts

23:01 2024 Trends Continued

25:21 Network Shares and Changes

28:09 Switching PPO Mix

30:32 Making Changes and Seeking Help

32:58 Conclusion and Contact Information

Shelley DeGroff Bio:

Shelley DeGroff, founder and CEO of PPO Advisors, knows dentistry. After graduating from the University of Nebraska, she began working as a dental receptionist in a nearby dental office. After completing her certification as a dental assistant, Shelley transitioned to become a successful office manager. It was in that role that Shelley began noticing the need for PPO negotiations for her employing doctor. This experience began the business model for PPO Advisors, which has now become a nationwide industry leader.