We become business owners, in part, because we want freedom. Freedom to practice the way we want, with who we want, on who we want. We want to control our own destinies, so it’s frustrating when you have another company interfering, in essence, with how you run your practice. When you write off 30-40%, you are, as Kirk points out, “working one out of every three days for free.” When you think about it that way, it makes you realize you need to change your relationship with PPOs. So many dentists want to reduce their dependence on insurance, but they just don’t know-how. To aid in this, we’ve released our ACT Dental PPO Roadmap.

The idea of dental insurance as a necessity is ingrained in patients because they’re thinking in terms of medical insurance, where they can only see a doctor if they’re on the right insurance. That’s not the case in dentistry, but patients don’t realize that. They know they’re paying full price when they buy a refrigerator or a car, so why do they think they can’t pay your full fee? 

At ACT we’re not inherently anti-PPO; instead, we’re pro-insurance independence. The goal is to have enough patients who pay 100% of your fee so that if you chose to drop all your PPOs, you’d still be profitable enough to pay your bills. Going fully fee for service is often the narrative—and don’t get me wrong, I love fee for service—but every dentist and practice is unique, so you need to find your sweet spot. When you have enough people that choose to come to you because they value the service you do and are willing to pay your full fee, then it becomes easier to lower the amount of PPOs you’re on and lower your dependence on insurance.

High Volume, Low Satisfaction

With PPOs, the only way to offset the write-offs is to increase the number of patients you see. We hope that the high volume of new patients will outweigh how much we’re giving away, but this is challenging because margins are decreasing with PPOs and will never increase. Dental reimbursement goes down while costs go up, so the margin just gets tighter and tighter. The high-volume game is a vicious cycle because you must take so many more patients to make up for what you write off, so you’re working that much harder. As a result, your schedule is booked out for weeks in advance, so if a patient without insurance, who wants to pay your full fee, tries to get an appointment, they can’t get in because you don’t have an opening for six weeks. So they go elsewhere, and you’re stuck, because the math of continuing to work harder for a decreasing margin just doesn’t make sense. How do you escape?

Break Free of Fear

Getting away from PPOs seems like an insurmountable task because we’re afraid to do it. And the reason we’re afraid is because we don’t know how. There hasn’t been a lot of great guidance, so we fear the ramifications of cutting PPOs, but you can eliminate that fear by having strategy, knowledge, and a step-by-step process. Our PPO Roadmap does exactly that. In the Roadmap, you won’t actually cut any PPOs until late in the process, and by the time you hit that last step of getting rid of your two worst PPOs, it’s an easy decision because you’ve spent so much time: 

• Collecting data
• Setting up your office for success with procedural operational changes
• Training your team
• Calibrating your mindset
• Ranking your PPOs

The Roadmap walks you through setting yourself up for success, so that last step is such an easy one to take. You don’t necessarily need to cut all your PPOs, but the Roadmap will identify the ones that shouldn’t be on your list, so you can see more people who will pay 100% of your fee. When that happens, you’ll be able to work a little less, a little easier, and have the ability to be a better dentist, parent, and leader because you’re not working with roller skates on. As Kirk says, “at the end of the day, it’s life” that we should focus on, because that’s what truly matters. 

Dropping a PPO will become so easy, but only after you’ve put in the work. Download the free ACT Dental PPO Roadmap and find out how you can start the journey to insurance independence. Join the Inner Circle and the To The Top Study Club, and you’ll have peers to walk with you every step of the way. And of course, reach out to the ACT coaches for help implementing the Roadmap in your practice. You don’t have to wear yourself out chasing a decreasing margin—you can work less and make more by working smarter. You’ll create more time and give yourself a Better Practice, and a Better Life!

Dr. Barrett Straub is a former ACT client, a general dentist, and the Director of Education at ACT Dental.