Many dentists may consider dropping a PPO a scary proposition. Will they lose a lot of patients? Will they lose a lot of money?
Which plan should you drop?
Sure, you can just look at your fee schedules and see which plans pay you the least and you can certainly start there. But you should also speak with your front desk team about which plans are playing games with your cash. Just because a fee schedule lists a D2740 at $800 does not mean you can expect to collect that much. Third-party payers can downgrade procedures (often shifting costs to the patient), exclude procedures, or otherwise generate red tape that makes it more difficult to get paid what you’re owed.
How much of a hit will you take?
Use your practice management software to find out how many patients will be affected by your decision. Estimated about 8
% of the patients were on Plan X, so that was the worst-case scenario in terms of patient loss. Can your practice take a hit like that? Retaining a portion of those patients, we’ll at least be generating better revenue from that chair time. Which leads me to . . .
Have a plan to retain patients
You’ll have improved patient retention if you can present patients a solution when you break the news that you’ll no longer be in network with their plan. Some offices try to convert the patients over to an in-office membership plan. Others charge their regular fees and hope patients will be satisfied with reimbursement checks from the third-party payer. You may offer a discounted fee schedule (technically not a membership plan as there are no annual fees) and any checks from Plan X will go straight to the patient.
Have a plan for replacing patients
.You can still drop a PPO if your office is not currently at capacity, but you should seriously consider starting marketing campaigns prior to cutting the cord.