PPO’s and In House Membership Plans

PPO’s and in-house membership plans. As the dental insurance industry continually lowers your reimbursement, many are dropping PPO’s or being in network. Offering patients an alternative such as an in-house membership program will increase your reimbursement and lower your adjustments. Why does anyone work twice as hard; see twice as many patients just because they are in network and have to offset their revenue? However, before you drop your PPO’s, assess the patient demographics. How many patients are you in network with? Have you run an analysis on which ones are allowing a reasonable reimbursement and those that are not. Is your patient base comprised of numerous insurance plans that you could opt out of just a few? Does your Active Patient Base allow you to take this step without emptying your schedule? Do you have an in-house membership plan you can offer your patients? When setting up a membership plan, customize it to meet your patient base needs. If you opt to stay in network, have you renegotiated your fees? 95% of the dental practices I have worked with complain about their reimbursements (I’ve had practices adjusting up to$500,000!) but do nothing to change this. Make informed decisions. Work smarter not harder.  Fed up yet?  Let’s talk…..nancy@klassolutions.com

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