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The Dental BoardroomAuthor: PracticeCFO
A place for dentists to find expert insight and information around everything from navigating residency and associate opportunities to being a successful dental practice owner. Language: en Genres: Business, Courses, Education, Entrepreneurship Contact email: Get it Feed URL: Get it iTunes ID: Get it |
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166: Dropping PPOs: The PPO Squeeze
Episode 166
Monday, 21 September, 2026
Participants:Wes Read, host, PracticeCFOMegan Shelton, a practice management consultant specializing in dentistry who previously owned and sold her own dental practiceMichael Anderson, a dental marketing consultant with 13 years in the industryDuration: 60 minutesReimbursement is flat while overhead climbs, and most owners have at least daydreamed about dropping Delta. This session breaks the decision into three levers, price, friction, and yield, and argues that the fee schedule is rarely the real problem. Friction, the cost of collecting the money, is what owners actually control.Key topicsUCR fee schedules and percentile benchmarkingClaim denials, eligibility, and breakdownsPer-plan profitability mathMarketing readiness before going out of networkKey takeawaysThe squeeze is often the cost to collect, not the fee schedule.An 80 percent PPO practice can still be highly profitable.Not every plan delivers the same patient; case acceptance varies by carrier.A practice with no marketing history will struggle to go fee for service.Actions to considerRun a UCR percentile analysis and raise fees toward the 80th to 85th percentile, then resubmit.Pull payer distribution and case acceptance by plan to find your worst performer.Verify eligibility within two days of every visit and get a full breakdown, not a coverage table.
