Dropping PPO dental plans is no longer a fringe idea, it’s a growing trend. As reimbursement rates shrink, costs rise, and administrative burdens pile up, many dentists are wondering if staying in-network is still worth it.
But before you cut ties with PPOs, you need a plan. Going out-of-network can be liberating, but without proper preparation, it can hurt your patient base and revenue. Here are 5 steps every dentist should take before parting ways with PPO dental plans.
1. Analyze Your Revenue Breakdown
Before anything else, get clear on how much of your income is tied to PPOs.
- What percentage of production comes from each plan?
- Are certain plans consistently underpaying for procedures like core buildups, crowns, or periodontal therapy?
- Are write-offs eroding your profit margins?
Use your practice management software or ask your billing manager to run a report. Many dentists are surprised to learn they’re barely breaking even, or losing money in some cases, when seeing PPO patients.
Pro tip: Identify which plans are most damaging first. You don’t have to drop them all at once.
2. Audit Your Fees and Raise Them if Needed
Going out-of-network means you’re no longer locked into a PPO fee schedule, and that’s a big opportunity.
- Evaluate your usual, customary, and reasonable (UCR) fees.
- Compare them to regional averages.
- Adjust them to reflect the true value of your services.
Raising your fees isn’t about overcharging – it’s about aligning your prices with the quality care you deliver. When you’re no longer writing off 30% or more on every procedure, you can focus on providing the best possible care without operating at a loss.
3. Improve Your Patient Communication Strategy
This is where many dentists make or break their transition. You MUST proactively communicate:
- Why you’re leaving the plan (ex. low reimbursements, care delivery limitations, etc.)
- What it means for the patient (ex. they can still come to you!)
- What new options you offer (see Step 4)
Use multiple channels: email, printed letters, front-desk scripts, and your website. Patients won’t be mad you left as long as you explain it clearly and show them you still have their best interests in mind.
4. Offer an In-House Membership Plan
One of the best ways to retain patients after dropping a PPO? Offer them a compelling, affordable alternative.
In-house membership plans:
- Provide discounts on preventive care and procedures that may not be covered at all by traditional insurance
- Eliminate insurance hassles for the dentist and patient
- Transparent pricing gives patients clarity and peace of mind
- Consider partnering with DntlDirect, a membership program offered to local employers
5. Get Listed Where Patients Are Searching Without Paying for Ads
Once you drop PPOs, you’ll need to attract more fee-for-service and membership plan patients. These patients often search for:
- “Best dentist near me”
- “Best dentist in [city]”
- “Dentist without insurance”
- “Affordable dental office in [city]”
Instead of spending thousands on ads or fighting Google’s SEO algorithm, get featured in third-party listings that rank for these terms, especially ones created by dental professionals such as DenScore’s “Best Dentist” listings that can be found in over 2,500 cities.
Final Thoughts
Dropping PPO dental plans can free you from frustrating restrictions, low fees, and excessive paperwork, but it’s not something you should do impulsively. With the right strategy, communication, and support, you can transition successfully and build a practice that’s more profitable, more fulfilling, and less dependent on insurance companies that don’t value your work.
Ready to Drop PPOs the Smart Way?
Contact DenScore’s Head of Partnerships at kyle@denscore.com to learn about an insurance alternative more dentists are choosing – one that pays better and drives more patient referrals than traditional plans ever could.
