The Difference Between “We Submitted the Claim” and “We Got Paid”** In PPO-driven practices, revenue doesn’t depend on what was diagnosed or even what was treated. It depends on how the claim was submitted. Two offices can perform the same procedure on the same day with the same insurance plan—and receive completely different outcomes. One […]
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Case Study: Billing Fixes That Recovered $120K in PPO Revenue
The Practice Didn’t Have a PPO Fee Problem — It Had a Billing Problem** When this multi-provider general dental practice reached out for help, the owner believed their PPO contracts were the issue. Production was strong. The schedule was full. New patients were steady. But collections lagged far behind expectations. Initial assumption: “Our PPOs just […]
Read MoreWhy PPO Claims Get Denied (And How Top Offices Avoid It)
Denials Aren’t Random — They’re Predictable Most dental offices treat PPO claim denials like bad weather: annoying, unavoidable, and mostly out of their control. But high-performing practices know better. They understand that PPO claim denials are patterns, not surprises. And patterns can be fixed. The difference between offices that constantly fight insurance and those that […]
Read MorePPO Coding Tips to Reduce Dental Claim Denials
Most PPO Denials Start With a Code, Not the Treatment When PPO claims deny, most offices assume one of three things: “That plan just doesn’t pay well.” “Insurance is always difficult.” “The treatment was clearly necessary — they should have covered it.” In reality, the majority of PPO denials are not about the treatment at […]
Read MoreDental Billing Best Practices That Protect PPO Revenue
Billing Isn’t Administrative—It’s Financial Strategy Most dental practices believe they have a PPO problem when, in reality, they have a billing problem. Production is strong. Schedules are full. Providers are busy. Yet revenue doesn’t reflect the effort. The disconnect almost always lives in the billing process—specifically how PPO claims are coded, documented, submitted, and followed […]
Read MoreHow to Prepare PPO Contracts for a Smooth Dental Practice Transition
A Smooth Transition Starts Long Before You Sell** Selling a dental practice is one of the most significant financial events in a dentist’s career. Most owners know they need clean financials, strong patient flow, and updated equipment to attract qualified buyers. But one area determines both your sale price and how smoothly the transition goes after the […]
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