Should You Cancel In-Network Insurance PPO Contracts?
CEO Training Case #CEO450
“Dr. Memo” (names have been changed) signed up for McKenzie Management’s Dentist CEO Training Course because she was purchasing the practice where she had been an associate for ten years. She wasn’t happy with the way the practice was currently being managed and wanted to make some positive changes. Her vision of a fee for service practice with limited PPO out-of-network was what she wanted to create from the current practice, which was in-network with six different PPO contracts and chaotic with the pressure to keep eight treatment rooms filled. Often Dr. Memo felt that trying to balance numerous staff to treat a large volume of patients was a break-even situation.
She was aware of total production and collection statistics, but didn’t know the breakdown of what accounted for in-network insurance, fee for service numbers, and out-of-network insurance numbers. She had heard from experts that it wasn’t wise to cancel any contract until she analyzed the impact each PPO contract had on production/collection numbers.
Most major dental software such as Eaglesoft and Dentrix can provide reports of this information with a search for the number of patients on a plan and the total production generated from each group. Your dental software support team can help you with this if it is difficult to find. Remember too that you must check the terms of each contract for instructions to follow when cancelling. Some plans require a 30-day notice, others require a year and some state that you must send a letter to all the patient members of your intentions.
Before you embark on a campaign to free yourself from dental PPO contracts, read the following list to make sure you have done your homework.
Before cancelling your PPO contracts:
Can your practice let go of the PPO?
Practice due diligence before pulling the plug on the PPO. To learn how to manage your practice for success, call McKenzie Management today and schedule a business training course.Forward this article to a friend
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