PPO Plan Questions Answered: The Complete FAQ for Dental Practice Owners

A: Yes. This concern is valid but usually exaggerated. Research shows that in virtually every market in North America, there are sufficient patients who value quality dentistry enough to pay full fees. The real question isn't whether patients exist—it's whether you can reach them effectively. This requires marketing systems (digital, referral, or community-based) that attract patients who aren't looking for the cheapest option. Most practices find there are more quality-focused patients available than they expected once they start actively marketing to them.

A: Readiness has four key components: (1) Strong patient relationships—do your patients value you beyond insurance coverage? (2) Marketing capability—can you attract new patients outside of PPO networks? (3) Scheduling demand—is your schedule nearly full? (4) Team alignment—does your team understand and support the transition? If you're strong in these areas, you're ready. If you're weak in any, address that first before resigni ng.

A: Always start with your lowest-paying plan. This accomplishes two things: First, you lose the least revenue initially. Second, you learn the process with lower stakes. Use that experience to refine your strategy before dropping higher-revenue plans. Most practices start with plans other than Delta (since Delta is often their largest) and gradually work their way to more significant plans as they gain confidence.

A: 12-36 months is typical, depending on your current situation and preparation level. Practices with strong marketing systems and relationship-driven models can accelerate this. Practices starting from zero marketing infrastructure may need longer. The key is that you don't necessarily need to drop all plans at once—you can phase them out gradually as you replace patients with fee-for-service clients.

A: 80-95% retention is typical for practices that handle the transition well. Some patients will switch to in-network dentists, but most stay because they value your care and relationship above insurance convenience. The practices that see only 50-70% retention usually have weak patient relationships to begin with or communicated the change poorly. If you have strong relationships and communicate face-to-face, expect to retain most of your patient base.

A: This requires a proactive new patient acquisition system in place BEFORE you announce your PPO resignation. Options include digital marketing (SEO, Google Ads, social media), referral incentives, community visibility, and personal relationships. The key is consistency—you need new patients flowing in regularly throughout your transition period. Many practices discover that their new patient marketing system becomes their best business acquisition tool long-term.

A: Negotiation is possible but often unproductive with larger plans like Delta. These companies have little incentive to negotiate—they know there are many dentists wanting to join their networks. Your leverage is limited. Unless they're offering meaningful rate improvements, negotiation usually wastes time you could spend on strategic planning. If a plan's fees don't work for your practice, resignat ion is usually the better choice than continuing to negotiate.

A: Start with education and transparency. Share your financial situation with your team—show them how much you're writing off, how fees are declining, and what that means for practice sustainability. Help them understand the benefits: less insurance paperwork, less administrative frustration, more time per patient, and a more sustainable practice. Then invest in training—communication scripts, fee discussions, objection handling, and role-playing. When your team understands the why and feels prepared for the how, they become your best advocates.

A: Schedule face-to-face conversations with your best patients first. Explain your reasoning clearly: declining fees, rising overhead, and your commitment to better care. Discuss their options—they can still use their benefits as out-of-network if they choose. Listen to their concerns and address them directly. Follow up with a letter to all patients explaining the change and your reasoning. The key is that patients need to hear it from you in a conversation, not discover it in the mail. Personal communication dramatically improves acceptance.

A: Be careful here. Legally, you need to be cautious about discriminating by insurance status, particularly with larger plans like Delta. The safest approach is to continue accepting new patients during your contract period but announce the PPO resignation with proper notice (usually 30-90 days depending on your contract). After the resignation is effective, then you stop accepting that insurance. This protects you legally while still allowing you to manage the transition strategically.

A: Collections typically improve significantly. Here's why: With PPO plans, you write off 30-50% of fees as insurance adjustments. When you go fee-for-service, you collect the full fee (minus the portion patients can't afford). Yes, some patients will pay less out-of-pocket because they're not taking their insurance coverage out-of-network. But overall, your collections improve because you're not giving away massive discounts to insurance companies. Most practices see 10-20% improvement in total collections within 12-24 months after dropping major plans.

A: Track these key numbers: (1) Patient retention rate—what percentage of PPO patients stayed? (2) New patient acquisition rate—how many new fee-for-service patients came in monthly? (3) Average production per patient—did this improve? (4) Collections rate—what percentage of production were you collecting? (5) Overhead as percentage of revenue—did this improve? (6) Team satisfaction—are your staff members happier? These metrics together paint a picture of whether your transition is working.

A: No. Insurance companies don't blacklist dentists for resigning—they understand it's a business decision. You can resign and rejoin later if circumstances change. Your resignation doesn't damage relationships with other insurance companies or impact your credibility. It's simply a business choice.

A: Phasing out gradually is usually better. It allows you to learn what works, refine your strategy, replace patients systematically, and maintain cash flow during the transition. Starting with your lowest-paying plan, then progressively working toward larger plans, gives you practice runs and confidence. It also reduces the shock to your practice. Some dentists successfully drop plans all at once, but they typically have very strong marketing systems and financial reserves to handle the transition.