Did you know an insurance company you’ve never met, never credentialed with, never signed a contract with

could be dictating your fees?

Welcome to one of dentistry’s favorite magic tricks: network leasing.

And no, this isn’t the fun kind of magic with applause and confetti. This is the “now you see your revenue, now you don’t” kind.

The Umbrella You Didn’t Ask For

Here’s how the game works.

You sign up with a PPO. You negotiate. You credential. You shake hands. You think, “Okay, at least I know the rules.”

But buried in the fine print is a clause that allows that PPO to lease or rent your contracted rates to another carrier through what’s often called an umbrella network.

Suddenly:

• A patient walks in with a logo you don’t recognize.
• Your team verifies benefits.
• The claim processes.
• The payment arrives.
• And it’s lower than what you negotiated.

You dig. You call. You wait on hold long enough to question your life choices.

And eventually you hear something like:

“Oh yes, Doctor. That claim was processed through a leased network.”

Translation: You’re in a contract you never consciously joined.

This is also known as the silent PPO problem, because it’s silent until your AR report starts screaming.

The Margin Erosion You Didn’t See Coming

Here’s the dangerous part:

This isn’t one bad claim.

It’s systematic.

When carriers stack and lease networks, reimbursement often defaults to the lowest available fee schedule in the stack. And guess who absorbs the difference?

Not the insurance company.
Not the employer.
Not the patient.

You.

Multiply that across hygiene, crowns, SRPs, and restorative, and suddenly you’re working harder for thinner margins without realizing why.

And then we wonder why practices feel squeezed even when schedules are full.

Congress Is Finally Noticing

The good news?

This lack of transparency is no longer flying under the radar.

Recent Congressional hearings have started putting pressure on nonconsensual network expansions and silent PPO arrangements. Lawmakers are asking the right questions:

• Who approved these network leases?
• Where is the provider consent?
• Why is reimbursement being altered without clear disclosure?

For years, dentistry has been playing defense. Now transparency is becoming part of the national conversation.

Will legislation fix everything tomorrow? No.

But the spotlight matters.

But Here’s the Real Question

Are you going to wait for Congress to protect your fee schedule?

Or are you going to protect it yourself?

At Veritas Dental Resources, we don’t wait around for regulatory miracles.

We peel back the layers.

We analyze stacked contracts.

We identify which umbrella networks are hitting your TIN.

We determine which fee schedules are actually being applied.

And most importantly, we work to leverage you into the highest paying allowable available within those network structures.

Because your skills shouldn’t be sublet at a discount.

The Hard Truth (With a Little Humor)

Dentists will negotiate a $0.03 price increase on composite.

But they’ll ignore a 15 to 30% reimbursement suppression happening quietly through network leasing.

That’s not a criticism.

That’s just how confusing this system is designed to be.

If the contract feels like it requires a decoder ring and a law degree, that’s not by accident.

It’s Time to Take Control

You worked too hard for your clinical expertise to let it get discounted in the fine print.

If your reimbursements don’t seem to match what you negotiated

If random logos are showing up on EOBs

If your production is steady but profit feels tight

It’s time to look under the umbrella.

Not to complain.

Not to panic.

But to optimize.

Because when you understand the game, you gain leverage.

And when you gain leverage, you stop playing defense.

You start winning.

Benjamin Tuinei
Founder – Veritas Dental Resources, LLC
📞 888-808-4513
Services: PPO Fee Negotiators, PPO Fee Negotiating, Insurance Fee Negotiating, Insurance Credentialing, Insurance Verifications
Websites: www.VeritasDentalResources.com, www.VerusDental.com