If you are an insurance company representative reading this then chances are you want to know a bit about us and our philosophy. We try to be as transparent as possible and are happy to share.
We are dedicated to helping the solo dental practice thrive in a complicated world of insurance participation. We are committed to supporting a solo/small group business model and do not accept contracts from chains or corporate practice models. We require our clients to sign a non-disclosure agreement which requires them to understand they may not share their proposed fee schedule with any other party outside of their office. We also let clients know that we cannot use a fee schedule they may have obtained from another office as leverage with negotiations. In fact, we will not even allow it to be sent to us for review. Our clients are required to give us a copy of their current full fee schedule printed from their dental practice management software which is what we use to submit to insurance companies when requested. We will not submit artificially inflated fees for the purposes of negotiations and we require that any fee changes must be fully implemented in their software and be in use before we will use those fees for submittal for negotiations. We are doggedly determined with our negotiations on behalf of the doctors we work with, but will not compromise the integrity of our company or the reputation we’ve established in the industry, nor will we ever put in jeopardy the dentist’s own standing and reputation with a carrier through our representation.
Our preferred path is always a direct contract with a carrier and that is our recommendation to doctors when at all possible. We may recommend a third party agreement for participation but may also recommend against it if the relationships are not clear and/or if the fee schedule exposes them to low fees on a large portion of patients.
Carriers that make it difficult to obtain information for doctors to evaluate or provide inaccurate information are carriers we will not recommend participation with because it is an indicator of communication challenges that may continue into the contracted relationship. Carriers that will not send us fee schedules directly, even with the doctor’s written permission, may add significant time to the negotiations/review process and tend to be less appealing choices for dentists. This is particularly true with start up practices who have time restraints.
We will recommend a doctor terminate a contract if we feel that participation is not in their best long-term interests but we will also recommend participation when it fits their business model goals and we encourage a strong long-term relationship with carriers that we feel would be a good fit for the doctor and the patients in their community. We will not recommend terminating a contract as a means of negotiation and will only recommend it if the doctor is prepared to follow through and plans to become an out-of-network provider.
We are aware that there are companies/consultants working today who have been found to alter documents and to encourage sharing of fee schedules between practices. We consider that action as something that has indirectly harmed countless individual doctors who are committed to doing the right thing and have hired an ethical company to support them in that goal. We work transparently because it is the ethical thing to do but it also supports our goal to facilitate a strong working relationship between a doctor and any carrier he has made the choice to be a preferred provider for and will only work with transparency.
We have worked with the corporate model and individual doctors who had a goal to move to the corporate model and have made the business decision to opt out of working with that model going forward. We refer to an alternative company that handles corporate negotiations when a practice with more than 2 locations contacts us. Our goal is to strengthen and sustain the solo dentist in this challenging insurance environment. Period.
If you have any questions about our company, we invite you to contact us personally by phone or email. Unlock the PPO is owned exclusively by the two of us. There is no corporate backing, no behind the scenes ownership, just the two of us who are hands-on with each and every client that gives us the honor of their business.
Lisa Weber and Sandi Hudson