Avoid hidden clauses that drain your revenue and limit your freedom.
Whether you’re opening your first practice or scaling your third, signing a PPO contract without understanding the fine print can cost you more than just money—it can limit your growth. Here are five common PPO contract red flags that every dentist should know before signing.
1. Reimbursement Rates Below UCR (Usual, Customary, and Reasonable) Fees
Don’t assume you’re getting a fair deal. Many PPOs offer fee schedules far below what other local dentists are earning. This means more patients, but less profit per visit. If you don’t know what practices in your area are getting paid, you’re negotiating in the dark.
2. Lack of Annual Fee Schedule Review Clause
Some contracts lock you into a rate structure for years—with no opportunity for adjustment. If there’s no built-in review process, you’ll fall behind inflation and peers, especially as your overhead increases.
3. Auto-Renewal with No Exit Clause
Buried in the legalese is often an auto-renewal clause with tight opt-out windows. Miss the 30- or 60-day cancellation notice? You’re locked in for another year—no matter how unfavorable the terms.
4. “Most Favored Nation” Clauses
This sneaky clause means if you offer one PPO a lower rate, you’re contractually obligated to extend that same rate to others. It’s like playing poker with your cards facing up.
5. Restrictions on Billing for Non-Covered Services
Some PPOs prohibit you from billing patients for non-covered services—even if the patient agrees in writing. This ties your hands and undercuts your ability to offer high-quality optional care.
⚠️ Why an Expert PPO Contract Review is Crucial
Most dentists don’t have the time—or legal training—to spot every hidden trap. That’s where a dental contract consultant comes in. A professional PPO contract analysis service can review your agreements, highlight risk areas, and negotiate better terms on your behalf.
✅ Take Action:
Before you sign, know the signs.