Episode 102: What are the Consequences of Staying In-Network with PPO Plans?
Play episode · 21 min
Many dentists, even though they know that they might be writing off hundreds of, thousands of dollars, in PPO write-offs, still choose to stay in-network.

In this episode, Gary and Naren discuss the consequences that can impact your dental practice and cause your business to suffer, if you stay in-network with PPO Plans.

Gary also shared solutions to all the consequences dentists may face due to being in-network.

 Highlights:

  * Introduction to today’s topic > 01:05
  * The backstory about this topic > 03:00
  * What are the consequences? > 04:22
  * Consequence #1: Overhead will go up > 06:48
  * Consequence #2: You will remain dependent on patients who come from Insurance > 10:19
  * Consequence #3: Frustration over patients who only want treatment covered by insurance > 11:24
  * Consequence #4: Challenge growing the high-value service component of your practice > 12:46
  * Consequence #5: If you continue to stay in-network, your practice will be vulnerable to the next crisis > 15:24
  * Recap of the five consequences for staying in-network > 18:27
  * The solution for these Consequences > 19:25

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 Transcript

Naren:

This is the Less Insurance Dependence podcast with my good friend Gary Takacs and myself, Naren Arulrajah.

Gary:

We appreciate your listenership, we appreciate your time and most of all we appreciate your intention to reduce insurance dependency in your practice. Our goal is to provide information to you that will allow you to successfully reduce insurance dependency and convert your practice into a thriving and profitable dental practice that provides you with personal professional and financial satisfaction. Welcome to another episode of the Less Insurance Dependence podcast, I am Gary Takacs your podcast cohost and I am very excited about bringing a topic to you that I know you are going to benefit from and the topic is what are the Consequences for Staying in Network with PPO Plans? Hey before we get tot to that episode though a quick announcement about our September thriving dentist MBA live stream workshop and man we had a great time on that you know that MBA workshop is all about the 10 elements of a thriving practice – it is an 8 hour course and during that 8 hour course I go through all of the 10 elements in detail it actually is a true workshop we have 11 workshop exercises throughout the day the exercises are all about helping you apply the information that you are learning we also have a 64 page workshop workbook to support you in applying this information and apply it in your practice – so they come join us in October we have another live stream format it is October 23rd and 24th that is a Friday Saturday, and you can find that we will put a link in the show notes just click on that link and it’ll take you right to the landing page where you could learn more about that October one day thriving dentist MBA live stream workshop – we have got some very attractive pricing, we have got some early bird pricing available for you. I will give you a heads up our workshops have been selling out we limit attendance because of the workshop format and they have been selling out if tickets are still available you can see that on the website and you can see some very attractive pricing. Hope to see you join us in the October one day thriving dentist MBA live stream workshop.

Naren:

Hello everyone this is Naren your cohost of the less insurance podcast show – I am excited to talk about today’s topic but before we jump in I just want to kind of give you the back story as to how you know we picked this topic recently Gary did a book club for his coaching clients and he discussed case presentation – a book on case presentation by none other than Doctor Frank Spear. It is an amazing book and everyone who was part of this book club conversation loved all the insights and the lessons Garry shared, and one of the things that stood out to us was what frank taught or talked about in this book – he makes it a point to talk to potential patients, the consequences of not doing anything and that kind of gave us an idea – many many many people even though thy know that they might be writing off hundreds or thousands of dollars in PPO write offs – still choose to stay in network. So we thought why not talk about the consequences of staying in network with PPO plans today – Garry does that sound good to you?

Gary:

Yeah let’s recognize Naren possible choice is to stay in network – in fact I might even go far s to say that that is the popular choice –

Naren:

Right

Gary:

That is what the vast vast vast majority of dentists will do however this choice has consequences and as you framed it so well – the book that we did in book club written by doctor Frank Spear – I love the way frank introduced the concept of always let your patient know in an informative way not a scary way – in an informative way what are the consequences of not doing any treatment. you know Naren I remember when Paul learnt that concept – he took a workshop from spear education and that was one of the core elements of this particular workshop and I remember when Paul applied it in our practice we were a solo dentist at that time and I remember when Paul applied it – and it was quite literally a break through when you present that for example Naren – I want to share this because I know our listeners can benefit from it. Let’s say our patient has old amalgam fillings – a mouth full of old amalgam fillings that might have been placed 25 or 30 years ago – maybe when they were a young adult when these old amalgam fillings were placed and the doctor can clearly see that they are breaking down but the one problem is nothing hurts and now what do some people think when nothing hurts?

Naren:

Those things are fine

Gary:

I don’t need to do anything! And as Frank would do that with a patient I would say something like you know Naren you might be wondering why do I need to do anything about this when nothing hurts and so I wanted to share with you what are the possible consequences of not replacing these amalgam fillings – well one possibility is because of the fillings now decay can get underneath those filings and cause more decay. Decay never solves itself – it only gets worse and if you wait till it hurts that decay maybe much greater than it is now – and we may need to do more aggressive treatment like a root canal and crown if we wait. If we can treat it now –we can treat it more conservatively and save more tooth structure and maybe save something a lot more complicated in the future I just wanted you to know what the possible consequence of not doing anything whatsoever

Naren:

That is a great tip Garry thank you for sharing it.

Gary:

So hey let’s talk about the consequences of sating in network because it is a choice – you don’t have to go out of network. However there are consequences to that choice – let talk in my mind there’s many many many consequences however I have thought of 5. Let me go through those – I’ll number them one through 5. number 1 – your practice overhead will continue to go up – because dental insurance companies will reduce your PPO fees even more so in the future now Naren I made that statement pretty badly – they will be lowering your contracted fees, now we can I say that so confidently Naren?

Naren:

Because they have done

Gary:

Because they have done it may times before!

Naren:

Exactly

Gary:

And that’s what they do yeah it happened recently in Arizona it happened recently as December – December of last year – they send a certified letter out all Arizona contracted providers with Delta and they just unilaterally said hey due to pressure from our clients – we are cutting your fees 15% - now notice the languor they used in the letter – due to pressure from our clients we have no choice but…
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