Obstacles or Opportunities
It’s time to put an end to providing free dental services at the mercy of dental insurance companies and their misleading guidelines. Additionally, bid farewell to misinformation and break free from dependence on dental advisors who lack the necessary expertise.
Discover how My Practice My Business (MPMB) can empower you to achieve fair compensation through PPO plans and, surprisingly, your self-pay patients.
Who are we?
At My Practice My Business, we blend practical dental experience with the insight gained from business degrees. Over the years, we’ve trained thousands of dental professionals, covering essential topics such as profitability, insurance protocols, effective case presentation, and dental state laws.
Q&A
Q: Can we charge PPO patients for more expensive materials and technologies?
A: Yes. You can bill PPO patients for enhanced materials and technologies, but it needs to follow specific protocols. Those telling you otherwise have never bothered to read, or understand, dental insurance contracts or the legal regulations governing dentistry in your state.
Q: Does my PPO patient’s out-of-pocket expense increase when receiving more expensive treatment options?
A: Yes. The additional costs fall on them. Reflect on this, Doctor: How much does your fee-for-service patient compensate you? Dental insurance states that they will only cover the “least expensive, professionally acceptable treatment” (LEPAT). Dental education and experience show that this may not always be the best option for the patient. So, unless dentists want to treat their patients to insurance limitations, the patient is financially responsible for more expensive options.
Q: Isn’t offering upgrades to patients akin to nickel-and-diming them?
A: Doctor, the only one getting “nickeled and dimed” here is you and your team. You’ve been on the receiving end of cost-cutting tactics from PPO plans because you haven’t taken the time to thoroughly examine and understand the contract you signed or the intricacies of state laws.
Q: Is it necessary to depend on a consultant or consider joining a DSO due to my limited business expertise?
A: No. How many of these self-proclaimed “experts” possess genuine hands-on dental experience with business degrees to back them up? Have they navigated payroll challenges, faced dental insurance representatives head-on, or been responsible for hiring and letting go of employees? At MPMB, we have done the above, passed state laws, and helped thousands of dental professionals. We firmly believe that dentists and their teams can acquire the necessary business skills to run a profitable practice without continual dependence on dental consultants or DSOs. We witness this every day.
Q: I’ve been told it’s illegal to charge for upgrades with PPO patients. Is this true?
A: No. Refer to a major insurance company’s statement below, which closely mirrors the policies of nearly all dental insurance companies:
“The provider must present the patient with an accurate and detailed breakdown of covered and non-covered services and their financial responsibility for each service whether covered or non-covered. If there are alternative upgrades to a procedure which are not covered, but the base procedure is covered, providers must explain that a covered benefit is available to the patient and the patient must sign their consent to receive any upgraded, non-covered alternative or additional services.”
—January 1, 2023 Operating Handbook
It’s time to face the facts: your current insurance compensation is based on providing the LEPAT, as outlined in your contract as a provider. This situation presents you with three choices: racing to the bottom by providing the cheapest dental care possible (resulting in financial losses), delivering high-end dentistry within a PPO budget (leading to even bigger financial losses), or a hybrid of the two (where you’re still losing money). You shouldn’t blame yourself – your education focused on dentistry, not business management. However, an alternative, more profitable option does exist: training with MPMB.
Q: Could charging additional fees for upgrades and value-added services lead to the loss of patients?
A: Numerous scholarly research studies have found that choice promotes trust. By educating and offering choices for your patients, you’re actually reinforcing the doctor-patient relationship. It’s important to remember that if you do lose a few patients, you are likely to only lose those patients who have been exploiting you and your team’s goodwill for too long.
Q: Training with MPMB seems expensive. How can I afford it?
A: When it comes to the affordability of our training, it’s important to note that we operate differently from other consultants. Our approach is rooted in a unique guarantee, meaning we only make money if you make money.
Here’s how it works: You start with an initial payment of $5,000, and the remaining balance is collected monthly on 20% of your new monthly production increase. This is based on new procedure codes you have never used before. In other words, we don’t get paid if you don’t increase net revenue. We believe that our success should be based on your success.
Once your tuition is paid off, you keep all the new net revenue generated. The only ongoing nominal monthly fee is for our educational and statistical web-based applications, ‘My Dental Docs,’ and ‘My Dental Stats. These tools transform case presentation, educate patients, and evaluate procedural profitability unlike anything found in the dental industry.