Planning Your PPO Negotiations

PPO negotiations are an exercise in communicating your value and focusing efforts appropriately to achieve agreement. For more than 10 years, Five Lakes has negotiated with payers to help clients achieve higher PPO reimbursements. As expert dental negotiators, our customized approach has resulted in millions of dollars of financial gain for our clients.

We are periodically challenged with the question from prospective clients, “how good are you?” or “can you do it better than me?” To answer this challenge, we wanted to share some about our process. Perhaps similar to an automobile service garage, at Five Lakes, we have a 20-point inspection.

For practices considering PPO negotiations, we will highlight some of the effort that goes into our 20-point process over the coming weeks. Today, we start with what.

What Are We Negotiating?

First, you must understand what you are trying to accomplish. What are the variables in a PPO negotiation between payer and provider?

  • Better PPO reimbursements?
  • Consistent fee schedule across multiple locations?
  • Customized fee schedule to incorporate specialists?
  • A shorter contract term ?
  • Admittance into an exclusive panel?
  • To include some providers in-network but not others?

Once you have identified your purpose to initiate a negotiation, you must next consider what you are looking to accomplish in terms of outcomes.

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PPO negotiations are an exercise in communicating your value and focusing efforts appropriately to achieve agreement. For more than 10 years, Five Lakes has negotiated with payers to help clients achieve higher PPO reimbursements. As expert dental negotiators, our customized approach has resulted in millions of dollars of financial gain for our clients.

We are periodically challenged with the question from prospective clients, “how good are you?” or “can you do it better than me?” To answer this challenge, we wanted to share some about our process. Perhaps similar to an automobile service garage, at Five Lakes, we have a 20-point inspection.

For practices considering PPO negotiations, we will highlight some of the effort that goes into our 20-point process over the coming weeks. Today, we start with what.

What Are We Negotiating?

First, you must understand what you are trying to accomplish. What are the variables in a PPO negotiation between payer and provider?

  • Better PPO reimbursements?
  • Consistent fee schedule across multiple locations?
  • Customized fee schedule to incorporate specialists?
  • A shorter contract term ?
  • Admittance into an exclusive panel?
  • To include some providers in-network but not others?

Once you have identified your purpose to initiate a negotiation, you must next consider what you are looking to accomplish in terms of outcomes.

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PPO negotiations are an exercise in communicating your value and focusing efforts appropriately to achieve agreement. For more than 10 years, Five Lakes has negotiated with payers to help clients achieve higher PPO reimbursements. As expert dental negotiators, our customized approach has resulted in millions of dollars of financial gain for our clients.

We are periodically challenged with the question from prospective clients, “how good are you?” or “can you do it better than me?” To answer this challenge, we wanted to share some about our process. Perhaps similar to an automobile service garage, at Five Lakes, we have a 20-point inspection.

For practices considering PPO negotiations, we will highlight some of the effort that goes into our 20-point process over the coming weeks. Today, we start with what.

What Are We Negotiating?

First, you must understand what you are trying to accomplish. What are the variables in a PPO negotiation between payer and provider?

  • Better PPO reimbursements?
  • Consistent fee schedule across multiple locations?
  • Customized fee schedule to incorporate specialists?
  • A shorter contract term ?
  • Admittance into an exclusive panel?
  • To include some providers in-network but not others?

Once you have identified your purpose to initiate a negotiation, you must next consider what you are looking to accomplish in terms of outcomes.

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PPO negotiations are an exercise in communicating your value and focusing efforts appropriately to achieve agreement. For more than 10 years, Five Lakes has negotiated with payers to help clients achieve higher PPO reimbursements. As expert dental negotiators, our customized approach has resulted in millions of dollars of financial gain for our clients.

We are periodically challenged with the question from prospective clients, “how good are you?” or “can you do it better than me?” To answer this challenge, we wanted to share some about our process. Perhaps similar to an automobile service garage, at Five Lakes, we have a 20-point inspection.

For practices considering PPO negotiations, we will highlight some of the effort that goes into our 20-point process over the coming weeks. Today, we start with what.

What Are We Negotiating?

First, you must understand what you are trying to accomplish. What are the variables in a PPO negotiation between payer and provider?

  • Better PPO reimbursements?
  • Consistent fee schedule across multiple locations?
  • Customized fee schedule to incorporate specialists?
  • A shorter contract term ?
  • Admittance into an exclusive panel?
  • To include some providers in-network but not others?

Once you have identified your purpose to initiate a negotiation, you must next consider what you are looking to accomplish in terms of outcomes.

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