Proper PPO management
is more critical today
than ever.
At Five Lakes, we work with practices to maximize their reimbursements when credentialing with PPOs. Having an experienced team on your side can often make a tremendous difference in your cash flow from PPO payments.
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 some of the top factors driving PPO participation decisions:
- 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 is crucial for attracting and retaining patients, as well as for 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.