If you've ever looked at your PPO reimbursements and thought, “Wait, they pay him how much for a crown?”—you're not alone. Dentists everywhere are discovering the painful truth: PPO fee schedules aren’t always fair, rational, or based on the quality of care you provide.

Nope. Sometimes, it’s just about who you know.

Welcome to the preferential treatment club, where the velvet ropes part for a select few—and the rest of us are stuck behind, yelling at a claims rep who’s been on hold longer than we have.

Let’s Talk About the Cream

In every industry, there are “preferred partners.” In dentistry, that means certain practices get bumped to the front of the line when it comes to reimbursements, credentialing, and—you guessed it—higher PPO fees.

These aren't necessarily the biggest offices, the flashiest ones, or even the ones with the best Yelp reviews. Nope. These are the practices that have mastered the unspoken art of relationship-building with insurance companies.

Call it schmoozing, strategic networking, or just good old-fashioned business acumen—it works.

“But I Submit Clean Claims!”

Yes, and that’s adorable.

Clean claims are a baseline expectation, not a golden ticket. The truth is, negotiating with PPOs is more like playing chess while blindfolded—and the other side is playing poker with loaded dice.

While most dentists approach fee negotiations with spreadsheets, analytics, and pleading emails, the ones who win the game understand something deeper:

Insurance companies are made up of people. And people favor people they like, trust, and know.

It’s not always merit-based. It’s often relationship-based.

Making Friends in Low Places (Without Selling Your Soul)

Now, before you throw your ethics out the window and start mailing gift baskets to Delta Dental, take a breath. We’re not suggesting you sell out, give in, or start hosting barbecues for claims reps (although… not the worst idea).

Here’s what we are saying:

You need to play the long game.

Get on the radar. Build familiarity. Understand how PPO networks operate—not just on paper, but behind the scenes. Get connected to the people who make decisions. The ones who can (and do) grant exceptions and discretionary increases to their favorites.

This isn't about bribery. It’s about strategic positioning. Just like in any other business sector, insurance companies develop tiers of preferred providers based on cooperation, perceived alignment, and yes… relationships.

So, How Do You Do That?

1. Stop Being a Stranger
   Most dental offices treat PPO reps like necessary evils. Flip the script. Be easy to work with. Be professional, responsive, and consistent. Don't be a doormat, but don't be a diva either.

2. Build Institutional Memory
   Insurance companies remember offices that document well, communicate clearly, and advocate persistently—but professionally. They also remember the offices that send 20 angry emails and a cease-and-desist before noon. Which one do you want to be?

3. Ask to Speak with the Right People
   Claims reps are not fee negotiators. But they do talk to people who are. Start learning who the decision-makers are at each company. Develop rapport. Your goal isn’t to be best friends—it’s to be recognized and respected.

4. Leverage the Power of a Middleman
   Here's where the secret sauce comes in: use a reputable PPO negotiation partner who already has these relationships.
   Think of it like this: would you rather show up at a Hollywood party alone… or with someone who knows the bouncer?

   Veritas Dental Resources has been building bridges with insurance companies for years. They’re not just playing the game—they’re helping dentists win it.

But Wait… Isn’t This Just… Gross?

Not at all.

It’s business.

Every other industry has layers of partnership-building, tiered access, and strategic collaboration. If dentists want to stop being treated like vendors and start being treated like valuable partners, we’ve got to understand how the game is played.

And here’s the good news: You can play it with integrity, transparency, and purpose.

The Long Game Is the Only Game

Preferential treatment doesn’t happen overnight. It’s not something you earn with one negotiation email. It’s something that builds over time—through consistency, professionalism, strategy, and yes… relationships.

So if your PPO fees are stuck in 2009 and your neighbor’s rocking 2024 numbers, it might be time to stop asking, “Why them?” and start asking, “Who do they know… and how can I get on that level?”

Partner up. Play smart. And don’t go it alone.

Because in PPO negotiations, nice guys don’t finish last—they just finish smarter… with Veritas Dental Resources in their corner.

Ready to stop watching from the sidelines and start getting treated like the favorite child?
Visit www.veritasdentalresources.com and let the real negotiations begin.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com