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 Revenues
Dental 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 MoreOptimize Your Dental Fee Schedule in 5 Strategic Steps
How to Align UCR Fees with Profit Goals, Reduce PPO Losses, and Build Negotiation Leverage Running a profitable dental practice doesn’t start with more new patients or fancier marketing— it starts with a smart fee schedule. If your UCR (Usual, Customary, and Reasonable) fees haven’t been reviewed in the last 18–24 months, you’re likely leaving […]
Read More📈 Case Study: How One Practice Used UCR Optimization to Boost PPO Negotiation Power
The numbers don’t lie: Most dental practices are leaving thousands of dollars on the table every month—and they don’t even realize it. Why? Because their UCR fee schedules are outdated, undervalued, and silently sabotaging their PPO contracts. In this case study, we share how one growth-focused dental practice overcame that exact problem—transforming a 40–50% write-off […]
Read MoreUCR vs PPO Fees: How to Bridge the Gap
Understanding the Role of Full Fees in PPO Negotiations and Practice Profitability If you’ve ever scratched your head wondering why you’re getting paid far less than what you bill—or why negotiating better PPO rates feels like a losing battle—you’re not alone. The gap between UCR (Usual, Customary, and Reasonable) fees and PPO (Preferred Provider Organization) […]
Read MoreHow to Set Dental Fees That Reflect Your Value
A Step-by-Step Guide to Building a Strategic, Profitable UCR Fee Schedule Whether you’re opening your first dental practice, acquiring a second location, or finally getting serious about profitability, your fee schedule isn’t just an internal document—it’s a strategic asset. Yet far too many practices rely on outdated methods to set their fees: • Guesswork • […]
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