Dental practices consider adding PPO participation for different reasons, including increasing patient flow, expanding PPO exposure, or improving overall strategy. However, adding PPOs without a clear evaluation can create long-term challenges related to reimbursement, capacity, and operational strain.
This page explains when adding PPO participation may make sense, what should be evaluated first, and why timing and analysis are critical before making a decision.
Adding PPOs Is a Strategic Decision
Adding PPO participation is not inherently good or bad. The impact depends on the practice’s current situation and long-term goals.
Some practices add PPOs to:
Increase PPO exposure
Support growth
Fill unused capacity
Other practices may already participate with PPOs but want to improve reimbursement rather than expand participation further.
The key is understanding why PPOs are being added and whether the practice is positioned to benefit from that decision.
Situations Where Adding PPOs May Make Sense
Practices With Available Capacity
If a practice has:
Open chair time
Underutilized hygiene schedules
Capacity to see additional patients
Adding PPO participation may help bring in additional patient volume without displacing existing patients.
Practices that are already operating at or near capacity should be cautious, as additional PPO volume can increase workload without improving collections.
Practices Focused on Growth or Expansion
Some practices are intentionally pursuing growth, including:
Expanding to multiple locations
Adding associates
Increasing patient flow
In these cases, PPO participation may support that growth strategy, provided the reimbursement structure is workable.
Evaluate Current PPO Performance First
Before adding any PPO participation, practices should understand how their existing PPOs are performing.
This includes:
Reviewing write-offs by insurance company
Identifying which contracts are producing sustainable reimbursement
Understanding where revenue is being lost
Without this baseline, it is difficult to determine whether adding PPOs will improve or worsen financial performance.
Understand the Impact of Write-Offs
Practices cannot evaluate PPO performance without accurately tracking write-offs.
Key considerations include:
Billing full cash fees on claims
Measuring the difference between cash fees and PPO reimbursement
Avoiding artificially low submitted fees that mask true write-offs
If write-offs are not visible, PPO decisions are based on incomplete data.
Capacity and Staffing Must Be Considered
Adding PPO participation typically increases:
Patient volume
Administrative workload
Demand on hygiene and clinical staff
Practices experiencing staffing shortages or limited hygiene availability should carefully evaluate whether they can support additional PPO volume without negatively impacting operations.
Long-Term Commitment and Flexibility
PPO contracts are not easily reversible.
Practices should consider:
Contract termination notice requirements
The possibility of shared network agreements attaching later
How difficult it may be to unwind participation once added
Adding PPOs should align with where the practice wants to be long term, not just short-term pressure or trends.
Avoid External Pressure and Comparisons
Practices are often influenced by:
Online forums
Peer discussions
Industry trends
However, PPO strategy should be based on the specific practice’s data, goals, and capacity — not what other offices appear to be doing.
Summary
Adding PPO participation can be effective when a practice has capacity, a clear growth strategy, and a solid understanding of current PPO performance. Practices should evaluate write-offs, staffing, and long-term goals before expanding participation to ensure PPO decisions support sustainable success.
