PPO Write-Offs: Your Insurance Carrier Is Stealing $42K/Year Per Doctor

PPO Write-Offs: Your Insurance Carrier Is Stealing $42K/Year Per Doctor

PPO Write-Offs: Your Insurance Carrier Is Stealing $42K/Year Per Doctor

Your contracted fee for an amalgam filling is $125. The PPO fee schedule says $78. That's a 38% write-off. You're contracted to accept that.

Multiply that across 200-300 procedures per month per doctor. A general practice averaging 40% PPO mix loses $28K-$42K annually in write-offs per doctor. A 4-doctor practice? $112K-$168K gone.

Worse: most practices don't track this by carrier. You don't know which plans are bleeding you hardest. United might be 32% write-off. Cigna might be 48%. You can't negotiate if you don't measure.

The fix: run a write-off analysis. Export your EOB data for the last 90 days. Group by carrier. Calculate percentage write-off for each. Sort by volume and write-off percentage together. The carriers with high volume AND high write-off are your negotiation targets.

One practice found that Cigna (representing 18% of their volume) was running 46% write-offs while United was 28%. They renegotiated Cigna's terms (lower volume threat = leverage) and reduced to 38%, saving $8,400 annually on that carrier alone.

You won't get rid of write-offs. But negotiating contract terms to target carriers is free money. One renegotiation takes 4-6 weeks. The ROI pays for itself in month one.

Demand your write-off breakdown from your practice software today.

Source: Insurance Fee Schedule Analysis (American Dental Association, 2024)