Dental Insurance Fees

What Providers Should Know About Improving Dental PPO Fees

As a dentist, you are required to have specialized knowledge about oral health, the teeth, mouth, and gums. But did you know you also need to have specialized knowledge about dental insurance plans? The truth is that dentistry is one of the few remaining health care professions where most providers will own or operate in a private practice environment.  You are a health care provider and also the CEO of your health care company.

Like any business, your dental practice must be able to make a profit from the services you provide.  Everest Advocates is here to help you understand how dental insurance companies operate, what steps you can take for improving dental fees, and how you can negotiate dental insurance fees in order to keep your business healthy.

Participating in a PPO

While you are not required as a dentist to participate in a preferred provider organization (PPO), it can be beneficial in many ways. Insured patients who have dental insurance through a provider are required to use in-network dentists for care (or pay a higher fee for their care), any many of these patients can be directed to your office.

One of the disadvantages of participating in a PPO plan is that you will be required to enter into a contract with the insurance company to provide dental services at a predetermined fee schedule.  It will be up to you and your staff to determine if you can make those fee schedules work for your office.

Reimbursement Rates and Dental Fees in a PPO

When you participate in a PPO dental plan, the reimbursement rates for specific procedures and care are already determined in a contract, but it is important to know that you are able to negotiate dental insurance fees directly with the insurance provider.  There are compelling reasons to negotiate a higher rate of reimbursement for your office.  There are also compelling reasons to choose some PPO plans over others. In order to maximize your insurance reimbursement it is best to have someone with experience to help you. .

At Everest Advocates, we work specifically with dentists to help them increase the reimbursement. Find out more about how we can help negotiate dental insurance rates and find the best PPO plans in your area.  Fill out our simple online form to request more information, or contact us at 844.GO.4.APPS (844.464.2777).