Burkhart’s Practice Support Team compiles data from practices we work with and have found it is a common practice for dentists to be contracted with four or more managed care plans as PPO providers.
The decision to be a participating provider with one or more contracted plans has both pros and cons:
- Access to a greater pool of new patients
- The ability to provide accurate estimates for patients from agreed-upon fee schedules
- Happy patients who appreciate the savings they receive when using an in-network provider
- High, sometimes VERY high, adjustments
- Remapping and downgrading of treatment, creating additional write-offs
- Complicated policies that are difficult for both the patient and the practice to fully comprehend
- The need for a higher level understanding of coding protocols and how those protocols impact potential reimbursement
For many practices the pros outweigh the cons, or the practice simply doesn’t feel empowered to make a change. The fear of losing patients can be overwhelming. It requires excellent verbal skills to maintain patient loyalty if a plan is dropped, and some practices aren’t sure they can pull it off.
There is something you can do to take back a bit of that lost power!
Dropping a plan isn’t always the best solution. A careful analysis must take place to understand the potential implications of that decision, including investigating the number of patients on each plan and the average adjustment required. There is a simple solution to help you thrive in the age of PPO contracted plans! Dive a little deeper into your coding protocols to make sure you are maximizing your reimbursements inside the sometimes-confusing world of managed care. Perhaps you can:
- Make a small shift in the timing of procedures
- Reconsider x-ray protocols
- Evaluate your higher profit procedural mixture
- Dive deeper into the hygiene contribution to production
- Study how your fees compare to the fee percentile in your zip code
- Examine your preventative care protocols
A Practice Analysis uncovers potential profit inside the practice. In fact, the average annual lost opportunity totals $182,450 per year in added reimbursements.
At Burkhart, we obsess over our clients. Your success is our success! Allow Burkhart’s consulting team to take a deeper dive into your coding protocols and identify lost opportunities. The best part? We provide strategies to recoup the lost production…and provide the service at no cost to our loyal Burkhart clients!
Request your Practice Analysis through your Burkhart Account Manager or the Practice Support Team.
What will your report find?
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