PPO management

We can’t afford to burn out our Front Office Managers in today’s dental hiring climate. Booking and production schedules are already time-consuming. The increased complexities and expertise required to manage PPO contracts have taken their toll on Front Office Managers. A better approach is to level the playing field with insurance companies by outsourcing PPO Management. Results include higher fee schedules, increased revenues, and happier Front Office folks. This means they will have more time to do beneficial work for the practice and patients. 

If I were in a room full of Front Office Managers (FOM’s) and asked what they like most about their job, they’d probably say things like providing good patient care, creating a great office experience, and working with committed professionals. I doubt any of them would say they enjoy dealing with PPO contracts or working with insurance companies. In fact, that probably would land at the bottom of the list. 

The Increasing Pain & Complexities of PPO Management and Insurance Payout 

It hasn’t always been this way. There was a time when managing the insurance side of the business was pretty straightforward and not that difficult. But over the last decade, the business changed as PPO insurance companies ramped up efforts to lower payments to dental providers. The most striking changes have occurred over the last five years. Part of insurers’ strategy is to make contracts as complex and confusing as possible, so it’s hard to understand what you even agree to. 

In other words, if you’re a Front Office Manager who finds PPO management a major pain point, there’s a good reason for that, and you’re not alone. 

I worked at a dental practice for nine years, most of the time as a Front Office Manager. So, I started PPO Advisors because I realized that providers weren’t getting a fair deal from insurers. I know from first-hand experience that it’s unrealistic to expect a Front Office Manager to have the time it would take to effectively manage the practice’s relationship with insurance companies. In reality, it’s a full-time job, and FOMs have multiple other duties and responsibilities. 

PPO Advisors works with Front Office Managers to take the pain out of your dealings with insurers. We have the industry experience and expertise to get better results for providers. For you, that means an efficient, streamlined process that will increase revenues without seeing more patients. It also means you have more time to do what you enjoy most about your job. 

Re-negotiate a Higher Fee Schedule 

Most practices accept whatever terms are in the PPO contract without negotiating a higher fee schedule. Insurers also don’t want providers to understand their tactics to forego the agreed-upon fee schedule and pay less for services. It’s like playing a game where one side sets all the rules without explaining them to the other players. Guess who’s going to win?

PPO Advisors know how the game is played. The first thing we’ll do is re-negotiate your PPO fee schedules. A 20% increase is typical – that’s 20% more revenue to your practice without seeing one more patient. We also make sure the contract doesn’t allow insurers a way to get around paying the fee schedule through things like lease share agreements. Insurance companies are always coming up with new ways to game the system. So, we are constantly looking for new strategies that could disadvantage providers. 

Credentialing – Never Fall Out of Network Again

Nothing is worse than explaining to patients who thought they were in-network that they’ll have to pay out-of-network fees because the office failed to re-credential. Credentialing is a constant challenge for practices. When a lapse occurs, it jeopardizes the trust and faith of patients. Some offices may inadvertently compound the problem by trying to issue a credit to a patient without realizing they might be at risk of committing insurance fraud.  

We make sure your office never has a problem with credentialing. You can choose to have us manage this completely, or we can support your in-house team. Either way, we’ll ensure you have a system that efficiently maintains the necessary credentials at all times for all your networks. 

Free Analysis – See Your ROI Before You Sign Up

Having been a Front Office Manager myself, I wanted to create a business model that made it easy for other managers to see the value of our services before they had to commit. That’s why PPO Advisors are the only firm in the industry to offer a free analysis with negotiations completed upfront. 

PPO Advisors does all the work of negotiating a higher fee schedule on your behalf before you become a client, so there are no surprises. Our business model works because once providers see the return on their investment, it’s a no-brainer for them to become clients. On the low end, our clients see an average increase of $40,000 due to higher insurance payments. For multiple providers, the increase is closer to $100,000, especially if the network fees have been neglected for a few years. That could mean more money for staff or updating equipment – either way, it’s a nice conversation with the practice owner.

The dental industry hasn’t adjusted to the reality that managing the insurance side of the business is a full-time enterprise. Too often, the expectation is that a good Front Office Manager can do it all. A decade ago, that was probably the case. Given today’s environment with insurers’ relentless drive to lower payments to providers, Front Office Managers need all the help they can get with PPO management. 

PPO Advisors offers a way to eliminate PPO management’s hassles while increasing revenues. Best of all, we make it possible for you to return to doing the things that make you feel good about your job. 

If you’d like to learn more about PPO Advisors’ services and how our free analysis works, contact us today.

Updated September 2022.

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