Bill Rossi: Advanced Practice Management

Bill Rossi and team are involved in the on-going management of over 260 practices and oversee more than $30 million of activity per month. Each year they do over 600 on-site consultations giving them perspective for giving practical, tactical advice.

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Bill Rossi

WHAT YEAR IS YOUR PPO IN?

All of us are aware that over the years, PPOs rarely give increases and those that do are rather meager. Meanwhile, reality marches on in dental offices where, especially post Covid, expenses like PPE, wages, etc. have gone up. But even before Covid, clearly PPO fee increases were not at all keeping up with the cost of doing business. 

Take a look at what you’re getting from the PPOs. You’ll find it interesting to note how they match up to real fees historically. My company has been doing fee surveys for over 30 years, so we thought you might find this interesting. (These fees were from the Minneapolis/St. Paul area and pretty representative of the nation averages.)

STANDARD FEE SURVEYS (Dr, compare to your current PPO fee allowances) 

You’ll see that many PPO fee reimbursements are at the 2005 level. That was over 15 years ago! Some of your PPO fees may be from before the turn of the century!

What Are You Going to Do About It?

You can try negotiating with insurance companies, but this is getting to be less and less easy for individual Doctors, especially when you are dealing with umbrella PPO plans. Sometimes the best thing to do is just drop.

If the conditions are right and if you and your team are prepared, you can leave a PPO and keep the majority of the patients. Patients do like you for more than your in-network benefits. If you find yourself running around in circles trying to keep up with fees from 20 years ago, you might inadvertently be creating the sort of atmosphere where people can only like you for your “in-network status.” Not the outcome you want!

 So, Doctors, remember you have more power than you think you do. If your patients like and trust you, the out-of-network benefits for most PPOs are good enough to keep most of the patients. For the PPOs that have punitive out-of-network benefits – well, sometimes it’s best to just get it over with and get out of participating with them. If your practice is otherwise healthy, you will be surprised at how well you can “heal up” over any losses. If properly prepared, you will also be surprised at how many patients you keep.

Post-COVID, your team members want “2022 level” pay, maybe you should too…

Bill Rossi