By: Angela Holland, Founder of Preferred Dental Solutions
Insurance Expert and Strategy Consultant for Dental Practices
PreferredDentalSolutions.com
It’s the end of the year… out with the old, in with the plans that work for you! One of the most common fears I hear from dentists is:
“If we drop a PPO, won’t we lose all our patients?”
The Truth
It depends; these decisions must be made with actual data.
There are times when termination is not only smart — it’s essential. When a PPO’s fees fall below sustainable levels, it can cost you more to participate than to opt out.
When Participation Becomes a Loss
- BCBS, for example, rarely negotiates.
- Their reimbursements are often close to Medicaid levels.
- If you’re paying associates or running a busy schedule with low reimbursements, that’s not insurance — that’s charity care.
Control the Narrative
The key is controlling the narrative. When you decide to terminate, you must communicate before the PPO does.
We always recommend sending a patient letter that positions your decision as one made in their best interest — maintaining quality of care and keeping your focus on what matters most: their health and outcomes.
Don’t Forget: PPOs Have Out-of-Network Benefits
Also, the whole reason a patient pays a higher premium for their PPO is to have out-of-network (OON) benefits.
If a patient has OON benefits (as most will), you should absolutely continue treating them!
Pair It with a Smart Transition Strategy
- Honor in-network fees temporarily during the transition
- Recredential smartly through secondary networks like Careington or Connection
By doing so, you’ll not only retain most of your patients, but you’ll also increase profitability with fewer write-offs.
The Bottom Line
Leaving a PPO isn’t about losing patients. It’s about losing unnecessary losses and making decisions based on actual data.
