For years, Dr. Janahgiri did what most new practice owners do—sign up with every PPO under the sun to build a patient base fast. And it worked… sort of.
His chairs were full. His team was busy. But his profit margins? Not so much.
Like many growth-focused dentists, Dr. Janahgiri found himself stuck in a cycle of high production and low profitability, particularly when it came to Delta Dental. Fortunately, that story didn’t end there—and this case study will show you exactly how PPO Negotiation Solutions helped flip the script.
Meet Dr. Janahgiri
Dr. Janahgiri opened his dental practice in 2011 with a clear goal: serve as many patients as possible, grow the business, and build a long-term career on a strong foundation. Like most dentists in competitive markets, he knew insurance participation was essential for growth—so he joined all the major PPO networks, including Delta Dental.
Over the next few years, the practice grew steadily, but something didn’t add up. Despite the increasing patient flow, profits lagged behind expectations. Overhead crept up. Write-offs ballooned. And Delta Dental seemed to be the biggest culprit.
The Problem: A 40–50% Write-Off Rate
By the time Dr. Janahgiri reached out to PPO Negotiation Solutions, his practice was writing off nearly half of its regular fee schedule.
Let that sink in:
✅ High-quality dentistry
✅ Full operatories
❌ Barely breaking even
Delta Dental had become a necessary evil. The volume was there, but the fees were so suppressed that profitability suffered—especially on big-ticket procedures like crowns, bridges, and endo.
To make matters worse:
- His team was overwhelmed with insurance verification and adjustments
- Delta’s communication was inconsistent and unclear
- There had been no fee schedule updates for years
In short, he was doing everything right—but still losing money.
The Referral That Changed Everything
Dr. Janahgiri was referred to PPO Negotiation Solutions by one of his billing specialists who had worked with our team before. After a quick discovery call, we completed a thorough analysis of his PPO contracts—with Delta at the top of the priority list.
Our findings?
- Delta was reimbursing below regional benchmarks across multiple codes
- The practice had significant leverage due to production volume
- Recredentialing deadlines were approaching, which provided timing advantages
- His participation tier was outdated and needlessly restrictive
We proposed a comprehensive, multi-phase strategy focused on fee optimization, credentialing cleanup, and ongoing PPO oversight.
The Solution: Strategic Delta PPO Negotiation
Here’s what we did—and why it worked:
1. Deep-Dive Contract Review
We analyzed every clause in his Delta contract, highlighting outdated terms, red flags, and areas for renegotiation.
2. Regional Fee Benchmarking
Using zip code-specific data and procedure volume, we built a custom benchmark that demonstrated underpayment by 15–35% on high-volume codes.
3. Credentialing Streamlining
We audited and managed his recredentialing process, ensuring he was in the optimal tier for fee negotiation and not stuck in a lower-paying legacy track.
4. Negotiation & Appeal Strategy
We submitted a well-supported fee increase proposal that emphasized:
- High patient retention
- Clinical quality and CE certifications
- Local competition and economic factors
- Rising operational costs impacting care quality
We followed up regularly, rebutted standard denials, and escalated the request to regional reps with authority.
The Results: A Game-Changing Transformation
Within 90 days of beginning our engagement:
✅ Delta Dental increased reimbursement on multiple high-impact procedure codes (up to 25%)
✅ The practice reduced write-offs from 40–50% down to 20–30%
✅ Monthly production nearly doubled within the next year
✅ Increased profitability allowed reinvestment into:
- Digital imaging tech
- Expanded hygiene hours
- Targeted marketing campaigns
Dr. Janahgiri also reported improved morale among his admin and billing teams—no more fighting to understand Delta’s vague fee schedules or navigating endless call center loops.
Why This Strategy Worked
Delta Dental is known for being tight-fisted. So why did this negotiation succeed?
Because we didn’t walk in cold.
We armed our proposal with data, demonstrated business acumen, and communicated with the right people, in the right way, at the right time.
Too often, dental offices try to negotiate PPOs the same way they manage collections—with a single form letter and fingers crossed. That won’t cut it with Delta. This case proves that strategic negotiation isn’t just possible—it’s profitable.
Words From Dr. Janahgiri
“I started using PPO negotiations in 2020. It has been one of the best decisions that I have made. They made a significant change into my network and it was a game changes for my practice. The owner, Tricia, is amazing to work with and the whole team is on top of their game. Just love them 🙂 highly recommend them to my fellow dentists. You won’t regret it.”
— Dr. Janahgiri, Practice Owner
What Could Your PPO Companies Be Costing You?
If you’re a growth-minded dental practice struggling to get ahead while accepting Delta Dental PPO patients, you’re not alone—and you’re not stuck.
Let us do for you what we did for Dr. Janahgiri.
Get a free Delta PPO analysis and see how much you’re leaving on the table.
👉 Request Your Free PPO Review Today