{"id":936,"date":"2022-08-30T15:18:50","date_gmt":"2022-08-30T15:18:50","guid":{"rendered":"https:\/\/blog.advancedpracticemanagement.com\/blog\/?p=936"},"modified":"2022-08-30T15:18:50","modified_gmt":"2022-08-30T15:18:50","slug":"dropping-a-low-paying-ppo-plan-and-limiting-the-damage","status":"publish","type":"post","link":"https:\/\/blog.advancedpracticemanagement.com\/blog\/dropping-a-low-paying-ppo-plan-and-limiting-the-damage\/","title":{"rendered":"Dropping a Low Paying PPO Plan and Limiting the Damage"},"content":{"rendered":"

In the January 15th Newsletter, we summarized how to best negotiate higher PPO reimbursements based on Bill Rossi\u2019s lecture at our Scottsdale, AZ seminar in late December.\u00a0 What follows is Bill\u2019s advice for dropping a PPO plan and limiting the fallout. \u00a0Dropping a plan is a serious business decision and demands careful consideration.\u00a0 This is not an ideal topic for this Newsletter, as the short format of the Newsletter items doesn\u2019t adequately capture the nuances involved.\u00a0 With that said, here are some recommendations:Don\u2019t drop a plan out of anger.\u00a0 Do it rationally.\u00a0 Before dropping, always try to renegotiate<\/u>.Ironically, dentists with the most PPO participation (usually 5 or more) are the ones least inclined to drop even though they are in the best position to do so. \u00a0It\u2019s not unusual to see these dentists collecting less than 75% of what they produce. If this applies to you, it is time to start peeling off some of them.You don\u2019t necessarily start with dropping the PPOs with the lowest fee schedule. \u00a0That is a major factor, but\u00a0the ideal PPO to drop represents a small portion of your patient base (say 10% or less) and has decent out of network benefits<\/u>.\u00a0 The process of dropping this smaller PPO is going to be a \u201cdress rehearsal\u201d for the bigger ones you may later decide to drop.When giving your notice to leave network participation, always be polite and leave the door open for the PPO to pay you more. Sometimes, if they didn\u2019t negotiate earlier, they will now. \u00a0In any case, keep the communications professional and positive.Ask them to send written confirmation to you confirming the date of the transition. Before the transition date, do not start telling patients. \u00a0Do not send letters! \u00a0These letters often aren\u2019t fully understood and can sound sanctimonious.\u00a0 Instead, train your staff to deal with patients both face-to-face and over the phone.\u00a0 They have to know how to tactfully address both old and new patients about your participation as \u201cout-of-network providers.\u201d \u00a0There are many nuances to this that go beyond what we can discuss here. \u00a0It\u2019s best to get professional help through this process.Be supportive of your staff<\/u>. \u00a0The more confident they are, the more calmly they will deal with this transition with patients and the better the patients will accept the change. \u00a0Keep in mind that\u2019s it\u2019s very likely you\u2019re\u00a0already\u00a0<\/em>seeing patients from various PPOs on an out-of-network basis.\u00a0 Patients are generally more loyal than you think.\u00a0 \u00a0Very few offices will be completely out of PPO participation.\u00a0 The goal is to find the right balance.It is also very important that you have a plan to fortify your practice<\/u>. \u00a0That is, you can\u2019t just drop the PPO and do nothing else. \u00a0You want to build up the practice through advertising, adding services, and tuning up your systems.The bottom line<\/u>: If you handle things right, chances are you\u2019ll lose the discounts and you\u2019ll keep the majority of the patients in any given plan. \u00a0There are substantial risks and rewards in leaving a PPO. \u00a0However, it\u2019s probably easier and less risky than you think it is<\/u>. There are few decisions that you can make that will add more to your bottom line, not just this year, but for\u00a0years<\/u>\u00a0to come. \u00a0You can\u2019t \u201coutrun\u201d the discounts forever.Massachusetts Dentists<\/u><\/strong>:\u00a0 Before you sign up with the \u201cNew\u201d Delta, or drop Delta altogether, it is very important to discuss the nuances of these decisions.\u00a0 Collier subscribers can call Bill Rossi at (952) 921-3360 if you\u2019d like to discuss this and get the \u201cinside baseball\u201d analysis of what\u2019s happening.<\/p>\n","protected":false},"excerpt":{"rendered":"

In the January 15th Newsletter, we summarized how to best negotiate higher PPO reimbursements based on Bill Rossi\u2019s lecture at our Scottsdale, AZ seminar in late December.\u00a0 What follows is Bill\u2019s advice for dropping a PPO plan and limiting the fallout. \u00a0Dropping a plan is a serious business decision and demands careful consideration.\u00a0 This is […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"wds_primary_category":0,"footnotes":""},"categories":[4],"tags":[],"class_list":["post-936","post","type-post","status-publish","format-standard","hentry","category-dental-practice-management"],"_links":{"self":[{"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/posts\/936","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/comments?post=936"}],"version-history":[{"count":0,"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/posts\/936\/revisions"}],"wp:attachment":[{"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/media?parent=936"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/categories?post=936"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.advancedpracticemanagement.com\/blog\/wp-json\/wp\/v2\/tags?post=936"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}