How to Increase PPO Practice Profits (Without Becoming a PPO Expert)

How to Increase PPO Practice Profits (Without Becoming a PPO Expert)

With so many demands on our time, the only thing many dental practice leaders want to do at the end of the day is to get home and rest. I get it.

But how can we improve our practices and reduce our stress if we do not change anything? We cannot. That does not mean we need to improve everything all by ourselves, though.

We can start to build momentum by outsourcing key tasks to experts who can do a better job and get started right away. You do not have to accept low profits and high stress for the rest of your career. That is no life to live.

The truth is it only takes six steps to maximize PPO practice profits. At least three of those can—and should—be outsourced to an expert. So, if you do not have an in-house expert who can handle these tasks, an outside expert might be the way to go. Here is how to find the right expert.

1. Commit to implementing the six simple steps to higher PPO practice profits.

Committing to following through with one clear plan is the best way to achieve any goal. With PPO practices, this is the six-step plan to maximizing profits:

  1. Negotiating higher PPO fees
  2. Implementing scheduling efficiencies
  3. Maximizing insurance on the front end
  4. Improving appointment efficiencies by implementing best practices
  5. Improving case acceptance
  6. Maximizing insurance on the back end

These work because they help you increase revenue and decrease costs. That is a nifty formula for maximizing profits in any business. So, if you are ready to increase your profits, commit to this plan and get ready to follow through.


2. Identify which steps you will keep in-house and which can be better outsourced to an expert.

Just because you commit to implementing the six-step plan does not mean you have to do it all yourself. In fact, you should not do it all yourself. All you need to do is know what needs to get done and have the right person to do each task.

I’m a big fan of outsourcing. Many tasks can be performed better by outside experts and at a lower cost. Hiring experts full-time is expensive. You need to pay for their expertise. They require higher salaries plus fringe benefits. And you pay their “expert” salary even when they perform tasks outside their area of expertise.

For those reasons, I recommend outsourcing insurance-related tasks to outside experts. You will immediately get expert-level performance without paying a full-time “expert” salary.

3. Find the right outside experts and structure a mutually-beneficial arrangement.

During my interview of Vivek Kinra, we discussed why he founded PPO Profits and how he works with practices. PPO Profits only works with a limited number of practices, but we can learn a lot from their structure. Here are three key takeaways from our discussion.

Pay Experts for Performance

Insurance experts generally charge a small percentage of collections for their work. For example, PPO Profits’ standard fee is 3.5% of collections after a $499 setup fee. (Vivek agreed to reduce both of those numbers for Nifty Thrifty Dentists. If you are considering hiring PPO Profits, be sure to ask for the Nifty Thrifty deal.)

To put the standard fee in perspective, assume your practice collected $1,000,000 in fees. Under PPO Profits’ standard rates, your total cost would be $35,499.

You would owe no employer taxes. You pay no fringe benefits. You do not have to manage vacation time. You do not have to schedule them. They do not call in sick. They do not get paid overtime. They do not get annual raises. And you do not need to train them. (In fact, they train you and your team to help you make even more money.) It is pretty standard to pay a percentage of collections for these types of services.

Pay Experts for Their Expertise

Talk with any company you are considering to understand exactly what you get from them. Some companies only do basic verification and work with just a few insurance carriers. They can help you become more efficient but cannot help you maximize profits. For example, they cannot advise you about whether all four quads can be done on the same day under a plan. True experts can, and that is one thing Vivek says distinguishes services like PPO Profits from others. It is what justifies the fee they earn by helping you reduce costs and increase revenue.

For example, doing all four quads on the same day saves you from scheduling two appointments. It saves you from preparing the patient twice. It saves you from filing two claims. It frees up time to serve more patients.

Those efficiencies gained can increase profits by much more than your outsourcing costs. Let’s continue using the $1,000,000 collections figure as an example. An increase in revenue of even 10% generates an extra $100,000 in revenue to your practice. That is $96,500 in extra revenue after paying the expert.

Paying experts for their expertise puts you and your expert on the same side. They are motivated to help increase revenue through their efforts and by helping your team work more efficiently. PPO Profits even coaches and trains their clients’ teams to help. They know if a few tweaks to the way your team performs can improve claim filing. Everyone wins. They tell you exactly what to collect from patients. They let you know exactly what needs to happen to get claims approved. If you need a statement from your patient, they let you know. They stay with you throughout the process. If an appeal is needed, they file it. They become true partners, meeting with you regularly to ensure continuous improvement.

When you work with true experts, you do not pay for processing. You pay for expertise.

Keep Commitments Short Term

True experts know the best way to establish long-term relationships is to earn that loyalty. That is why PPO Profits only charges a small setup fee to get started and do not require a long-term contract. Their setup fee of $499 gets them connected with your practice and pays them to get started. But they earn their real money by helping you collect money. (Make sure to ask for the Nifty Thrifty deal if you work with them.)

The only time they require a commitment is if you ask them to negotiate your PPO fees with insurance carriers. They will do it but ask you to commit to staying with them for a short period of time after the new rates go into effect. 


Are you ready to increase your profits without having to become a PPO expert?

Outsourcing insurance activities to an expert is a great way to start improving your profits without adding more work on your plate or having to become a PPO expert.

Whether you work with PPO Profits or another provider, these three points can help you maximize your results. If you do choose to work with PPO Profits, remember to ask for the Nifty Thrifty deal!

Finally, join the Nifty Thrifty Dentists Facebook community to watch my entire interview with Vivek and connect with thousands of other dentists building Nifty Thrifty practices.


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