Let’s be real—dental insurance companies are the worst. let’s talk about – Dental Insurance Fee Negotiation Letter
PPOs slash your fees, delay payments, and make you feel like you’re working for free. And the kicker? They couldn’t care less about your practice’s success.
If you’re tired of low reimbursements and writing off 30-50% of your production, it’s time to fight back. This article will show you how to negotiate better dental insurance fees, PLUS how to ditch insurance dependency altogether by scaling a membership plan that generates predictable revenue (MRR & ARR).
Oh, and if you haven’t checked out BoomCloud, you’re about to find out why it’s a game-changer. (Click here to learnmore)
Step 1: Negotiating Higher Fees with Dental Insurance
If you’re participating in Preferred Provider Organization (PPO) plans, you’re already getting the short end of the stick. But here’s the deal: insurance fee schedules aren’t set in stone. You can (and should) negotiate.
How to Write a Dental Insurance Fee Negotiation Letter That Works
Insurance companies aren’t going to willingly give you a raise, so you need to make a data-driven case. Here’s how:
1. Analyze Your Insurance Write-Offs
Pull 12 months of EOBs (Explanation of Benefits) and see how much each insurance company is underpaying you. If you’re writing off 40% or more of your production for a specific carrier, you’ve got a strong case.
2. Gather Competitive Fee Data
Compare your PPO fees with:
✔️ National Dental Advisory Service (NDAS) Fee Reports
✔️ Fair Health Consumer Database
✔️ Other Local Practices (Network with Colleagues!)
If your current reimbursement is below the 50th percentile, you should be demanding a higher fee schedule.
3. Draft a Killer Dental Insurance Fee Negotiation Letter
Here’s a sample framework:
[Your Dental Practice Name]
[Your Address]
[City, State, ZIP]
[Date]
[Insurance Company Name]
[Insurance Company Address]
[City, State, ZIP]
Re: Request for Fee Schedule Increase
Dear [Insurance Representative’s Name],
I am writing to formally request a review and adjustment of our contracted fee schedule with [Insurance Company Name]. Over the past [X] years, we have provided exceptional dental care to your policyholders while absorbing increasing operational costs and significantly reduced reimbursement rates.
Upon analysis, we found that our current reimbursement rates are below the 50th percentile of UCR (Usual, Customary & Reasonable) fees in our area. Additionally, our practice has experienced a 40% increase in costs related to supplies, technology, and staffing.
We respectfully request an adjustment of our fee schedule to reflect fair compensation for the high-quality services we provide. Enclosed, you will find:
- A detailed comparison of our reimbursement rates vs. regional averages.
- A breakdown of increased operational costs that affect our ability to sustain care.
- Evidence of our high patient retention and satisfaction rates as a preferred provider.
We look forward to discussing this adjustment at your earliest convenience. Please respond within 30 days so we can continue to deliver the best care to our mutual patients.
Sincerely,
[Your Name]
[Your Position]
[Your Contact Information]
Pro Tip: Follow up with a phone call after two weeks. If they deny your request? Threaten to drop them. Many insurance companies would rather negotiate than lose providers.
Step 2: Reducing Insurance Dependency with a Membership Plan
Even if you successfully negotiate higher fees, you’re still at the mercy of insurance companies. What’s the ultimate power move?
Build a membership program and take control of your revenue.
How Membership Plans Help You Escape the Insurance Trap
Patients pay YOU directly (No middleman = no BS).
Case acceptance increases because patients don’t stress about insurance limits.
You generate predictable revenue (MRR & ARR)—instead of relying on slow, unreliable reimbursements.
Step 3: How a Membership Plan Increases Loyalty & Revenue Per Patient
Fact: Membership patients spend 2X to 4X more than insurance-based patients.
Fact: They visit more frequently and accept larger treatment plans (like implants!).
Fact: They stay longer, increasing patient lifetime value.
Case Study: How BoomCloud Helped a Practice Generate $600K+ in Recurring Revenue
Dr. Samantha Lee, a dentist in Austin, TX, was fed up with insurance write-offs. So, she launched a BoomCloud membership plan to replace low-paying PPOs.
Results in 12 Months:
1,500+ patients enrolled in her membership program.
MRR hit $50,000/month (before adding treatment revenue).
Increased case acceptance for implants & major treatments by 70%.
Now, she has predictable income (ARR: $600K+) and full control over her revenue.
Want to launch your own membership plan? Check out BoomCloud
Final Thoughts: The Best Way to Grow a Dental Practice? Optimize Revenue Per Patient
If you’re serious about increasing profitability, here’s your game plan:
1️⃣ Negotiate better insurance fees – Stop letting PPOs rob you. Send that negotiation letter.
2️⃣ Reduce insurance dependency – Build a BoomCloud membership plan and get MRR & ARR on autopilot.
3️⃣ Increase Revenue Per Patient – Membership patients spend more, stay longer, and accept more treatments.
More revenue. More financial freedom. Less insurance drama. Sounds like a win, right?
Want to scale your practice with predictable revenue? BoomCloud can help.
Resources & Further Reading:
BoomCloudApps.com – The best tool for launching & managing membership plans.
ADA Dental Practice Report – Insights on insurance & practice trends.
DentistryIQ – Tips on maximizing practice profitability.
