Thinking about going out of network? I don’t blame you. After all, Dropping PPO insurances will ensure that you get paid fairly for your services instead of having to write off 20%-50% of the cost.

So if you’re ready to finally go out of network, keep on reading!

How to Drop PPO Insurances (and Get Paid Fairly for Your Services)

First things first, you’ll want to do your due diligence and evaluate whether or not you’re ready to go out of network and drop PPO insurances. A great indicator that you’re ready to drop PPOs from your ops is when your schedule is full. Even when you’re getting compensated for less than what you would like.

Another indicator would be if you’re ready to hire more clinical staff. If you’re thinking about adding 2 or 3 more chairs to your practice, you can ask yourself if you want to hire someone and add that extra chair, or do you want to drop some insurance companies to lose some lower reimbursement patients.

The trade-off there is that your overhead will stay the same, you’ll collect more, and you don’t need to add that extra chair.

Finally, if you have unscheduled treatment plans from the past 6 months that you can use to fill up your schedule, it might be a sign that you’re ready to drop PPO insurances.

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A Step-By-Step Breakdown of Dropping PPO Insurances

Removing PPO insurances from your ops can be intimidating and overwhelming. In order to simplify the process, The Dental Marketer University approaches this daunting task in 5 major steps:

• Creating a basic drop list
• Dropping your first plan
• Collecting fee schedules
• Advanced drop list
• Special considerations to be aware of

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4 Things to Do As You Get Ready to Drop PPO Insurances

Here’s a high-level overview of what you need to do as you get ready to drop PPO insurances.

First and foremost, you’ll want to communicate this change with your team. This is the first step that you need to take so that your team is completely aware and on board, so they’re ready to prepare the level of care they need in accordance with this big change.

Next, you’ll want to carefully select the insurance plans that you’ll want to drop. This is where the basic drop list comes in. It’ll help you stay organized and categorize all your insurance companies if you’re in a good handful of them.

Something to note as you’re creating your basic drop list if you’re in quite a few networks is you’ll want to continue running lists as you drop them so you can keep a close eye on any loose ends you need to tie (such as website updates).

Third, you’ll want to start contacting these insurance companies. A fair word of warning, dropping insurances can take more time than you think. Some of these companies will be dragging their feet as they’ll have waiting periods. So be prepared that this step is a process.

Finally, as you’re simultaneously contacting these insurance companies, you’ll want to contact your patients and update them about these changes coming to your practice.

Things to Keep in Mind As You’re Dropping PPO Insurances

There are a few things you’ll want to acknowledge as you’re dropping PPO insurances:

• Your team: Dropping insurance might make your team worry that their hours are going to get cut. You’ll want to reassure them that it isn’t going to affect their hours and that it is more about providing quality care.

• Choosing your first plan: To help you get started, the best thing to keep in mind is to start small and avoid dropping an all-or-nothing plan. 

• Contacting insurance companies: Getting into a network can be a bit of a headache. But so can getting out of a network. The most important thing of note is that once you drop an insurance company, your patient will likely get a letter from the company notifying them of other practice options that are within their network. This is why you’ll want to update your patient simultaneously to let them know what’s going on and why you’re doing this to improve the quality of their care. And of course, don’t forget to keep track of the plans that you’re dropping.

• Contacting patients: One thing that will help you navigate this change is pulling a report of all the patients that will be affected in the process. You’ll also want to draft up a template or script for what you’re going to say to these patients as you start reaching out to notify them of this change. 

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Some Important Things You Want to Include in Your Letter to Your Patient

There are a few key components you don’t want to miss as you begin drafting your letter or script template to your patients.

Obviously, you’ll want to include…

• The family name
• Insurance company
• Out of network date

Aside from the basics, you’ll also want to let them know that…

• They can continue to be a patient and utilize their insurance even though they’re out of network (unless they’re on an all-or-nothing plan)
• Reassure them that this decision was made to improve the quality of their care
• That you’re happy to look into your plans and help them navigate this change

And finally, you’ll want to end this letter with your practice’s contact information along with your doctor’s signature.

P.S. You can download and print this checklist here!

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Ready to Drop PPO Insurances and Go Out of Network in 2022?

There’s a lot more that goes into dropping PPO insurances and going out of network. However, this article is a great starting point so that you can get a clear overview and understanding of what the process might look like.

If you’re ready to drop PPOs from your practice this year, The Dental Marketer University just released an everything-you-need-to-know course by Dr. Ben Burkitt all about strategically dropping PPOs.

Throughout the course, you’ll have an in-depth, step-by-step guide on:

• How to drop your FIRST PPO
• Creating your basic PPO drop list
• Creating your advanced PPO drop list
• And what to do next