PPO fee schedule analysis
Dental PPO fee schedule analysis
Know what every PPO plan truly pays your practice. PPO Genius™ compares each network's fees against your production, so you can rebalance your plan mix or step away from a network with confidence.
What's included
Plan-by-plan comparison
See what each network pays for the procedures you perform most.
Contract priorities
Know which contracts to revisit first and which networks work best for your practice.
Fee schedule accuracy
Catch the wrong fee schedule attached to a plan in your PMS before it creates incorrect estimates and write-offs.
Office fee review
Office fees (UCR) that are not updated regularly quietly limit what you collect.
Network evaluation and benchmarking
Your fee schedules compared against market benchmarks, so you can see which networks are worth your chair time and which sit below market.
How it works
Step 1
Gather
We collect your fee schedules and production data.
Step 2
Analyze
PPO Genius™ compares plan performance across the procedures that matter most to your practice.
Step 3
Decide
You get clear priorities for revisiting contracts, rebalancing, or leaving networks.
The network-change write-off trap
When a practice moves from one network to another, or under an umbrella plan, re-signing can take 30, 60, or 90 days or more.
Until the new contract is active, those claims may process out of network. Teams often apply the new fee schedule early and write off the difference between the new rates and the office fees. Post payments, adjustments, and patient responsibility exactly as the EOB or ERA shows.
The fee schedule process for us was made simpler with PPO Genius, a feat we thought was impossible! We now know which insurance companies we need to change our contracts with.
One practice used its fee schedule analysis to secure a 22 percent increase in its Aetna fee schedule. Results vary by practice, plan, region, and payer.
Common questions
Does PPO Genius tell us which plans to drop?
It shows what each plan pays against your production and which contracts need attention. The decision stays yours, with clear numbers behind it.
Can we use PPO Genius on its own?
Yes. PPO Genius™ is also available as standalone software at ppogenius.com.
How do we get a quote?
Every practice is different, so pricing depends on the services you choose and the size of your practice. Schedule a consultation and you will get a clear quote for your practice.
What does the analysis cost?
The initial fee and network analysis is $699. Ongoing analysis and underpayment review in PPO Genius™ is $199 per month, or $2,200 per year. Start RCM service within 60 days of your analysis and the $750 setup fee is waived.
Can we run the analysis ourselves?
Yes. PPO Genius™ is our self-service platform for practices that want to analyze and optimize their own fees. See ppogenius.com.
Pricing
$699 initial fee and network analysis
Ongoing analysis and underpayment review in PPO Genius™ is $199 per month, or $2,200 per year. Start RCM service within 60 days of your analysis and the $750 setup fee is waived.