By: Angela Holland, Founder of Preferred Dental Solutions
Insurance Expert and Strategy Consultant for Dental Practices
PreferredDentalSolutions.com
There’s a long-standing myth in dentistry that PPO fees are fixed. That’s what you’re paid and it’s what you’re stuck with.
Let me be clear: that’s simply not true.
Every week, we help dental practices negotiate substantial increases, sometimes 20%, 30%, or even 60% higher reimbursements, all for an average of 28% through strategic fee negotiation and network optimization.
The problem isn’t that PPOs can’t pay more; it’s that most practices don’t know how to ask.
The myth comes from how networks are structured. Most practices are credentialed through umbrella networks or third-party administrators like Zelis, Careington, or Connection. Within those layers, there are multiple fee schedules and opportunities hiding in plain sight.
Negotiation isn’t about sending a fee schedule and asking for a bump. It’s about leveraging your:
- Data
- Production
- Patient volume
- Market position
…to prove your value to the payor. It’s strategic, not passive.
And here’s the truth: even if you don’t negotiate, your PPO is negotiating with someone else’s practice. The only question is whether you’re part of that conversation.
You deserve to be paid what your care is worth. And it starts by rejecting the myth that PPO fees are untouchable. Having a partner in your PPO strategy is no longer a luxury but a necessity in today’s PPO world.
Friendly reminder for the new year: increase UCR fees annually by 3-5% and make sure you are always in the 80th-90th percentile for your UCR fees. Low UCRs are hurting your future negotiations more than you know!
Make 2026 your best year yet!
Photo by Karola G
