Added overhead expenses, including increased employee compensation, supply costs, and inflation are forcing many practices to evaluate their managed care plans.

While inflation is starting to slow in 2023, hovering at 5%, overall consumer goods are 13% higher than they were one year ago.1 Yet, dental benefit plans have remained static in their reimbursement rates and annual maximum allowable. In response, dental practices are critically evaluating their participation levels. Let Burkhart’s Practice Support Team help.

The decision to be a participating provider with one or more contracted plans has both pros and cons:


  • Increased 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 adjustments with plans that are not responding to requests for renegotiation.
  • 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, creating higher staff salary overhead.

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 communication skills to maintain patient loyalty if a plan is dropped, and some practices aren’t sure they can pull it off. We can help.

There is something you can do to take back a bit of that lost power.

Dropping a plan isn’t always the best solution — at least not immediately. Your practice must have a strong foundation that incorporates long-range treatment planning, excellent coding protocols, target marketing, and verbal scripting for the team.

Careful analysis must take place to understand the potential implications of dropping a plan, including investigating the number of patients impacted, the average adjustment required, and your average annual per patient value.

Considering dropping a plan? Dive a little deeper into your coding protocols to make sure you are maximizing your reimbursements inside the often-confusing world of managed care.

Perhaps you can:

  • Make a small shift in the timing of procedures for greater reimbursement.
  • Review your fluoride usage and how it aligns with your philosophy of care.
  • Evaluate your higher profit procedural mixture.
  • Dive deeper into the hygiene contribution to production and periodontal treatment philosophy.
  • Study how your fees compare to the fee percentile in your area.
  • Examine your preventative care protocols.

A PPO and Practice Analysis uncovers potential profit inside the practice. In fact, the average annual lost opportunity found in our Practice Analyses so far in 2023 has averaged $176,178.79 per year in added reimbursements.

At Burkhart, we obsess over our clients and your success. Connect with Burkhart’s consulting team to take a deeper dive into your coding protocols and managed care reimbursement levels to identify lost opportunities, or help you move through a successful change in network status while retaining the maximum number of patients. The best part? We provide strategies to recoup the lost production. And we provide the service at no cost to our Burkhart Platinum and Supply Savings Guarantee clients! Request your PPO Analysis through your Burkhart Account Manager or the Practice Support Team.


Your success is our success. Please reach out to us anytime.
Learn more, visit the Practice Support Team page, email us at, or call 1.800.665.5323.

Burkhart Dental Supply – Practice Support Team

Category: Practice Consulting

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