For decades, dentists have accepted PPO write-offs as just “part of doing business.” But in today’s economy, being an in-network provider without negotiating your fees is more than inconvenient—it’s financially dangerous.

If you’re feeling squeezed lately, you’re not imagining it. You’re working harder. Overhead is rising. Profit margins are shrinking. And yet, the checks from insurance companies haven’t gotten any bigger.

Why? Because PPO write-offs are only part of the story.

You’re also battling:

• Rising inflation

• Increased operating costs

• Higher taxes on small business owners

• Stagnant reimbursement rates from PPOs—some of which haven’t been updated in 10 to 15 years

The result? Many practices are losing not just income today, but millions of dollars in long-term wealth.

Let’s break down the numbers—and talk about what you can do to stop the bleeding.

PPO Write-Offs: The Most Obvious Loss

Let’s start with what you already see: the discounts you take as an in-network provider.

According to data from Dental Intelligence and other consulting groups, the average PPO adjustment is 42–45% across general practices. That means for every $1,000 of dentistry you perform, you’re collecting only $550–$580.

Now zoom out over time.

A typical dentist will write off $3 to $6 million in PPO adjustments over the course of a 30–35 year career.

That’s not revenue lost—it’s income you earned, and then gave away.

The Silent Strain: Inflation and Rising Overhead

While your reimbursements stay flat, the cost of running a practice continues to climb every year:

• Supplies and lab fees are up 10–20% in just the last 3 years

• Payroll costs are rising due to wage inflation and staffing shortages

• Rent, utilities, and equipment costs are higher than ever

And unlike most industries, you can’t raise your prices at will—because your biggest payers (insurance companies) won’t let you.

If you haven’t negotiated your PPO fees in 5–10 years, you’re still collecting 2012 rates in a 2025 economy. That’s a losing game.

Taxes: The Other Cut You Didn’t See Coming

As a dental practice owner, you’re not just a clinician—you’re a business owner. That means you’re paying:

• Federal income tax

• State tax (in most states)

• Payroll tax

• Self-employment tax (on your pass-through income)

• Property tax on equipment and leaseholds

So when PPOs pay you $600 for a crown that should be $1,200, and then Uncle Sam takes another 30–40% of what’s left… your real take-home pay on that procedure might be less than $400.

And that’s before paying your team, your lab, and your bills.

The Lifetime Cost of Ignoring PPO Negotiation

Let’s be conservative. Say you do $1,000,000 in annual production, with 80% coming from PPOs. If your average write-off is 45%, that’s $360,000 you’re losing every year.

If you don’t negotiate your fees and stay in-network your whole career:

Over 30 years, that’s $10.8 million in write-offs.

Now, no one’s saying you can eliminate write-offs completely—but many dentists leave hundreds of thousands on the table simply because they never negotiated their PPO fee schedules.

The Solution: Start Negotiating Now

Most dentists don’t realize this, but PPO fees are negotiable—especially if you:

• Are opening or acquiring a new practice

• Have strong production history

• Are up for recredentialing

• Can show competitive value in your area

And you don’t have to do it alone.

Partnering with a trusted firm like Veritas Dental Resources allows you to:

• Audit your PPO participation

• Negotiate higher reimbursements

• Identify low-paying plans to drop

• Clean up duplicate or conflicting umbrella network contracts

• Maximize revenue per patient without adding more work

Some doctors see 10–30% increases on major codes just from one round of negotiations. Over time, this could mean tens (or hundreds) of thousands of dollars in reclaimed income.

Evaluate. Renegotiate. Reclaim Control.

If you’re an in-network practice today, it’s not too late. But you must take action.

Here’s your first step:

1. Evaluate your PPO contracts.

2. Know your write-off rate for each plan.

3. Negotiate your fee schedules—or outsource it to experts.

4. Consider dropping plans that are no longer profitable—strategically.

Remember: the PPO model is built to serve the insurer. Not you. Not your patients.

So unless you step in and advocate for yourself, no one else will.

Final Thought: If You Don’t Negotiate, You’re Funding Someone Else’s Profits

Dentists are under more pressure than ever before. PPO write-offs are just the start. Inflation, taxes, and administrative burden are eating away at the profession we love.

But the solution isn’t to work longer hours or see more patients—it’s to get paid fairly for the work you’re already doing.

Your talent, your time, and your team deserve better than bottom-tier reimbursements.

So take back your power. Start by partnering with Veritas Dental Resources to fight for the fees you deserve—and build the financial future your career should afford you.

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