New York is an expensive place to run a dental practice. Now think about what your PPO pays you for that same work. That gap is the whole problem.
At Five Lakes, we renegotiate PPO contracts as part of our PPO management services for New York dentists and get you better rates from Delta Dental, Guardian, EmblemHealth, and the rest. Our team also handles the credentialing paperwork nobody wants to touch.
We’ve been doing this since 2010. Over 6,000 dental offices have worked with us nationwide. Plenty of them are in New York, which means we already know the payers you’re dealing with.
Why New York Dentists Lose Money on PPO Contracts
Companies like Delta Dental of New York are their own company with their own rules, their own portal, and their own credentialing process. Advice built for a dentist in Ohio won’t help you here.
Guardian runs its own show too. EmblemHealth has its own network setup. Each payer wants something different from you, and each one has its own timeline.
Most dentists just sign what gets put in front of them. They figure it’s not worth the fight.
So they stay busy, see plenty of patients, and still feel like the money isn’t adding up. Meanwhile, a leased network clause is quietly skimming off the top of every claim. Nobody told them to look for it, but we do.
Complete PPO Services in New York
PPO Credentialing for Startups
Opening a new practice? We get you credentialed before you see your first patient. Applications, follow-ups, and payer communication all get handled by our team. You open your doors ready to bill instead of waiting months for approvals.
Dental Credentialing and Fee Negotiations
We handle the entire credentialing process for established practices too. Delta Dental of New York, Guardian, EmblemHealth, and MVP all have their own requirements. Our experts know each one and manage the paperwork from start to finish. Fee negotiations happen alongside credentialing so you start with the best possible rates.
PPO Contract Audits and Fee Schedule Reviews
We review your current contracts and compare every fee to New York market averages. Underpaid procedures get flagged. Missed renegotiation windows get identified. You get a clear picture of where you stand and what needs to change.
Ongoing PPO Management and Support
Ongoing payer management keeps your revenue steady. We monitor contracts, track payments, and handle issues as they come up. You get consistent support without adding headcount to your office.
PPO Education for Your New York Team
We teach your staff how PPO networks actually work. Understanding how PPOs impact your accounts receivable helps your team catch problems early. Knowledge saves you money month after month.
Where We Work in New York
Downstate looks nothing like upstate, and we treat each region differently. We perform marketplace evaluations to boost your growth as a practice or DSO.
New York City
NYC is the most crowded dental market in the country. Manhattan, Brooklyn, Queens, and the Bronx are packed with practices competing for the same patients. Patients here have plenty of options, which makes standing out harder. Being in the right networks at competitive rates is how you stay booked.
Long Island
Nassau and Suffolk counties have a large number of patients on employer-sponsored plans. That means PPO participation matters a great deal here. We make sure your rates match what those plans actually pay in this region.
Westchester and the Hudson Valley
Westchester and the Hudson Valley sit somewhere in between the city and upstate. These areas have suburban practices, a mix of payers, and county-by-county differences that catch people off guard. We know how each county’s payer landscape differs and build your strategy around it.
Upstate New York
Buffalo, Rochester, Syracuse, and Albany each have their own payer mix and patient base. Overhead is lower than downstate, but so are many fee schedules. We help you find the reimbursement number that actually works for your market.
Who We Help
Solo dentists who are tired of guessing. Group practices adding providers and locations. DSOs that need contracts standardized across every site instead of a patchwork of old agreements.
If you’re opening a new practice, we can get you credentialed before you see your first patient. If you’re buying one, we can sort out the contract mess before it becomes your problem.
Over 1,675 practices work with us nationwide. We’ve brought in more than $1.5 billion for clients in 2024. Nearly 50 startups get credentialed by our team every year.
Those numbers matter less than this: we pick up the phone.
FAQs from New York Dentists
How much more could I realistically get paid?
Depends on your contracts and your market. Most of our clients land somewhere between 15% and 35% higher on the contracts that will negotiate. We’ll tell you what’s realistic after we look at your numbers.
How long does New York credentialing actually take?
Delta Dental of New York runs 90 to 120 days. Guardian is usually 60 to 90. Others fall somewhere in that range. We stay on top of every application so nothing sits idle.
Can you handle a DSO with locations all over New York state?
That’s a big part of what we do at Five Lakes. We get every location on the same fee schedules and the same contract terms.
What if I don’t even know what contracts I have right now?
That’s more common than you’d think. We start by building a full picture of your current participation. You can’t fix what you can’t see.
I’m just opening my practice. Is it too early to call?
It’s actually the best time to call our team. Getting credentialed correctly from day one saves you months of lost billing.
Get PPO Solutions That Work For You
If you’ve ever finished a busy month and wondered where the money went, you’re not alone. That feeling usually means your contracts aren’t working for you.
Our Five Lakes team can tell you exactly where the gaps are with a clear look at what your payers should be paying you. If your dental office is in Manhattan, Brooklyn, Buffalo, Albany, or somewhere in between, call (440) 636-1378. You can also request a consultation with us online.