PPO Traps Dentists Miss: Contracts, Fee Schedules, and Hidden Networks

Do you really know which PPOs you’re contracted with — and how you’re contracted with them?

In this episode of the Dental Billing Academy Podcast, hosts Dr. Iris Han, DDS, and Jacquelyn Hurley are joined by Phyl Curtis of Unitas PPO Solutions to break down the PPO traps that catch dental practices off guard — from leased networks and umbrella contracts to fee schedules that aren’t what they appear to be.

Together, they explore how practices can unknowingly be in-network with PPOs they never directly contracted with, why the fee schedule you’re being paid from may not be the one you think, and why PPO decisions made out of frustration can create bigger problems down the road. Whether you’re considering dropping a PPO, negotiating your fees, or simply want to understand what your billing team should be watching for, this conversation will change how you look at your contracts.

In this episode, you’ll learn:

• How you can be in-network with a PPO you never directly contracted with
• Why the fee schedule you’re being paid from may not be the one you think
• What your UCR fees have to do with PPO reimbursement
• Why your billing team shouldn’t assume “that’s just what insurance paid”
• What your billing team should be watching for on every EOB
• What to consider before negotiating your PPO fees
• Why dropping a PPO is more complicated than it looks — and how to do it right
• What to look at before moving out-of-network

Want to know if you could be getting better reimbursement from your PPOs? Visit unitaspposolutions.com to review your contracts and understand your options. And if insurance billing, outstanding claims, or aging A/R are taking too much time, visit dentalbilling.com to see how eAssist Dental Solutions can help.