PPO Negotiation Solutions

We Level The Playing Field Between Dental Practices and Insurance Companies

dental practice fees

How Much Should You Increase Your Fees in 2025? 

Now is the time to review your practice’s performance and set new goals. Adjusting your dental practice fees should be a top priority as part of this process.

Many dentists feel uneasy about raising fees, often worrying they’ll alienate patients. This apprehension is understandable—discussing treatment costs, insurance coverage, and out-of-pocket expenses can be uncomfortable. However, it’s vital to recognize that regular fee adjustments are essential for maintaining a healthy, profitable practice. Just as expenditures for rent, supplies, equipment, and salaries rise yearly, your fees must keep pace.

Why Raising Fees Is Essential

If your profit margins are around 35% of gross collections, it may be time to increase production, improve collections, or raise fees. According to recent data from Burkhart Dental’s 2024 report, most practices should consider annual fee increases of around 5%, although the final percentage may vary based on economic conditions.

 How to Approach Fee Adjustments

  1. Focus on Key Procedure Codes

Start by balancing your fee schedule. About 30 procedure codes typically represent 90% of billable production in most practices. Ensuring these key codes are competitive and sustainable is critical.

  1. Use Reliable Data Sources

Look for accurate fee benchmarks within your geographic region. Dental supply dealers, insurance claim companies, or professional consultants can offer reliable data. Fair Health is one option, as it uses aggregated billing data from private practices across the country.

  1. Adopt a Unified Approach

Instead of adjusting individual fees based on patient or insurance perceptions, implement an across-the-board increase once a year. Incorporate this into your practice calendar to maintain consistency.

Communicating Fee Changes

Most patients are only familiar with hygiene fees or costs from recent treatments. Since fees for larger procedures might not have been top of mind for years, a modest annual increase usually goes unnoticed. However, large jumps—such as 10% or more—can unsettle patients. Small, steady adjustments ensure you remain competitive and cover rising costs without creating sticker shock.

Consequences of Delaying Fee Increases

Putting off fee increases can hurt your practice in several ways:

– Difficulty affording new equipment, software, or repairs.

– Inability to offer raises, benefits, or invest in updated technology.

– Risk of becoming the “cheapest dentist in town,” reducing the perceived value of your care.

Patients who value modern, high-quality dentistry will notice if your equipment appears outdated or if your practice lacks the latest technology. In cash-based practices, it’s especially important to emphasize added value, exceptional service, and state-of-the-art care to stand apart from the competition.

Aligning Fees with Financial Goals

If you’re not meeting your financial targets, that’s a clear indication your fees may need an update. Begin by setting realistic revenue goals for the coming year, then adjust fees to support those objectives. This proactive approach helps you stay on track with costs, grow your practice, and remain competitive in your market.

Moving Forward

Raising fees isn’t just about boosting revenue—it’s about sustaining a practice that’s well-equipped, profitable, and capable of delivering top-notch care. By taking time now to evaluate and adjust your fee schedule, you’ll position your practice for continued growth and success.

Schedule your fee adjustments, communicate them effectively to patients, and remain transparent about the value you provide. With a careful, consistent approach, you’ll maintain a thriving practice that patients trust and appreciate.

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10 Tips for Private Equity Stockholders and DSOs to Optimize PPO

Insurance negotiations and credentialing are essential parts of maintaining a dental practice. To have the most profit, negotiations for fee schedules will need to be done regularly and by someone who is trained and familiar with the processes. Providers credentialed with a variety of insurance will benefit from the most patient flow and retention. Let’s look at 10 easy tips to optimize these negotiations and, ultimately, guarantee patient retention.

Know Your Current Situation

It is important to understand the importance of PPOs, and how they affect patient retention in your practice. Be well-informed of your current PPO contracts. Review your current fee structure and parameters of all contracts. Are your contracts affecting multiple DSO locations, if applicable? Next, make note of the annual revenue for each PPO in each of your locations. For example, if your dental practice is close to a major company, like a hospital, it would be beneficial to explore their dental provider benefits.

Maintain a Stable Environment

Credentialing and negotiations, while necessary, can be a lengthy process. High employment turnover can affect the process and can drastically impact patient turnover and revenue. It can lengthen the process due to new employees needing to be credentialed or trained on new policies. Try to maintain your workplace and staff, to ensure adequate patient flow during the credentialing and negotiation processes.

Review Standard Practice Fees

The reason to review fees is to maintain the price of services and safeguard against inflation and neglect. Standard fees should be reviewed regularly by someone who values input from different departments. Also, consider factoring in multiple outside data sources to ensure your team has made an accurate assessment. If adequate, then use the data for your pricing model and to renegotiate adequately for new fees when the time comes.

Define Your Desired Outcomes

To be successful, define your objectives and goals early in the negotiation process. Your goals may change throughout the process. As goals change, ensure you are also developing success plans for each goal. It is recommended to have both short-term and long-term goals that are measurable and attainable. Each goal should have objectives or steps to achieve the result. Once goals are set, circle back and monitor your progress frequently to ensure you are staying on track.

Develop a Process to Collect and Analyze Data

Analyze your current process for collecting, processing, and comparing data. How can your current process be improved to be most efficient? Having a goal for analyzing processes is needed to ensure that no time or money is being wasted on insufficient processes. Once you have fine-tuned your process, monitor and periodically reassess for improvements, asking yourself if goals are being achieved in a timely manner.

Be Patient, but Persistent

Like mentioned earlier, negotiation and credentialing processes can be lengthy and time-consuming. Having an expert team working on negotiations can make for a smoother process. Maintain open communication and communicate frequently to ensure the process is running efficiently and to avoid delays. It may be helpful to set benchmarks for responses and follow up with representatives if responses are not received timely. If you do have a specialized team performing these duties for you, make a point to be in frequent communication with them to ensure they are following up on contracts efficiently.

Respect Confidentiality

It is important to honor confidentiality agreements without exception. Using an unrelated organization’s compensations in a negotiation is irrelevant and a confidentiality breach. Promote and emphasize confidentiality to all team members. Breaching confidentiality can negatively impact your DSO contracts and patient retention.

Communicate Proactively

Be prepared for questions from those not involved in the decision-making process, especially when big changes are being implemented. Understandably, the changes may incite anxiety in some team members. Examples of change include adding new plans or becoming out of network with payors. Communicate updates with staff throughout the process and, if necessary, provide training and support to help them adjust and be efficient in their roles.

Keep Track of Agreements

Keep track of all new agreements. The effective dates will vary throughout the year. Every agreement should be honored for at least two years before negotiating again. For example, review monthly which contracts are ending and plan to follow up with negotiations. Staying on top of negotiation contracts will ensure your practice is getting the best fees.

Obtain Adequate Resources

As your dental organization grows, there will be more profits at stake when negotiating with insurances. Use your most educated experts to assist in negotiations. If needed, contact a professional third party for managing the tasks of credentialing and negotiations. PPO Negotiation Solutions can increase your practice revenue and assist in streamlining your processes for improved outcomes. Contact the professionals today and let them help your practice thrive!

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