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PPO Management

Proper PPO management
is more critical today
than ever.

Most dentists are leaving money on the table with outdated PPO contracts. At Five Lakes Dental Practice Solutions, we work with practices to maximize their reimbursements when credentialing with PPOs.

We help you negotiate higher fees, optimize which plans you join, and monitor payments to catch errors. 

Having access to dental practice solutions and an experienced team on your side can often make a tremendous difference in your cash flow from PPO payments.

Our PPO Management Track Record

Our Five Lakes team has years of proven experience in PPO management.

  • 6,000+ dental offices helped since 2010
  • 15-35% average fee increase on negotiable contracts
  • $1.5 billion collected for clients in 2024
  • 50 states – we work nationwide

We can also negotiate with all major national payers:

  • Delta Dental
  • Cigna
  • MetLife
  • Guardian
  • United Healthcare

And regional plans in all 50 states. Some HMO and discount plans cannot be negotiated. We will review this with you during a consult.

Why are more successful dental practices participating in PPO insurance?

Over the past 10 years, there has been a major shift in dental benefit enrollment. Today, nearly 80% of dental patients have access to dental benefits. This makes the reasons for participating in PPO Insurance networks that much more important to the long-term success of your practice.

Here are the top reasons practices participate in PPOs:

  • Competition for patients is increasing.
  • More Americans than ever have dental benefits.
  • Consumers are more cost-conscious.
  • The number and size of DSOs continue to increase.
  • Rapidly increasing ER Healthcare premiums.
  • Heightened emphasis on in-network providers.

Developing A PPO Participation Strategy

 PPO negotiations are one part of a comprehensive strategy for your insurance participation. We understand how the right PPO participation strategy can make a significant positive financial impact on your practice.

Five Lakes provides the most comprehensive analysis in the industry to give us the data we need to negotiate successfully. In addition, for more than 10 years, Five Lakes has worked to build relationships with payers to drive optimal results.

Before you begin negotiations, it is important to review and set your office fees. Since most dentists price services comparatively, your pricing strategy should incorporate market data and reflect your business model.

Five Lakes works with you to successfully manage the key steps in partnering with a PPO.

Align Participation With The Market

To make informed decisions about PPO participation, you need to understand your competition, community profile, and the market share for insurance companies in your area. We provide the data analysis necessary to support your decision-making process.

Practice Assessment

In developing an ideal PPO participation strategy, business owners must know their practice. Utilization, patient and payer mix, and other important factors are all key elements in the overall plan. Our team partners with you to identify your practice needs so that your participation strategy can support practice growth.

Update Your UCR

Managing your office fees can help you attract and retain dental patients. Fee management also contributes to more successful PPO negotiations.

PPO Negotiations & Optimizations

To maximize reimbursements, practices should regularly negotiate and learn how to effectively leverage network sharing agreements when appropriate. We have the experience your practice needs to navigate and understand this complex negotiation process.

PPO Management for DSOs & Multi-Location Groups

Does your DSO need PPO management for multiple office locations? We help DSOs:

  • Standardize PPO contracts across all locations
  • Negotiate higher fees using multi-location leverage
  • Integrate newly acquired practices into your existing contracts

 

Client Review
Justin V.
From the start, Five Lakes has been professional, insightful, and overall extremely efficient at executing plans we discuss without needing much of my time. They've negotiated fees on our behalf, optimized plans that were impacting our office, and have allowed us to truly be a PPO practice for our patients while not being so heavily affected by adjustments. The analysis gives you insight on factors you wouldn't have considered while outlining real figures of your practice. The optimization & negotiation phase took place without consuming much of my time. Our ongoing support makes recommendations, continues to provide insight on figures, and works with you in identifying areas of growth.

Get PPO Management from the Experts

Are you ready to increase your dental practice’s PPO revenue? We will review your top PPO contracts and tell you exactly where you can get higher rates. Call Five Lakes Dental Practice Solutions at (440) 636-1378​ or request a consultation with us online.

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