by: Bill RossiGoing through a PPO transition is serious business. It is one of those moves in dental practice management that has substantial risks and rewards like adding an associate or building a new facility.So as dentists “balance” their PPO participation and decide to peel off some of them, I offer the following suggestions based on many years of helping clients through this process.It’s always better to talk face to face with patients about this transition. Letters are rarely thoroughly read, sound self-serving and can confuse and irritate patients.I know because a long time ago I used to help write those letters! I found it wasn’t the best approach.However, if a doctor insists on writing letters, we suggest sending them out a small batch at a time and following up with phone calls—just like you would with a recall notice. In this way, you can adapt and tailor your message. A mass sending of letters can seriously damage a practice.Remember, the goal when a client leaves a PPO is not just to minimize the loss of patients; it’s to slow down any loss. That gives the practice time to “heal up.” So, if the practice is otherwise well managed and has decent new patient flow, it will be fine.Slowing down the loss is another reason not to send letters. If you do things face-to-face, you’ll see every patient at least one more time. Face-to-face communication is always best especially when it’s a potentially difficult subject.As far as deciding which PPOs to peel off, it’s not just a matter of which ones have the lowest fee schedule. There are other key factors, such as the number of patients on the plan, out-of-network benefits for the PPO (plans with good out-of-network benefits are easier dumped than plans with no or puny out-of-network benefits), how many of the doctor’s patients are on the plan and how many new patients are brought in through the PPO.If the conditions are right and things are handled well (the staff coached, the groundwork done, etc.) a PPO transition should result in less than 30% of lost patients from that plan in the first year. However, I ask my clients, “If you lost 50% of the patients on this plan, would you be okay?” That is sort of a gut check.We keep very close track of the statistics before and after a PPO transition. We watch new patients, total patient flow and, of course, production and collections, as well as some other key statistics. That is how our approach to transition has evolved. Doctor, you do have the power to peel off bad PPOs!Bill Rossi is President of Advanced Practice Management. He and his team are actively involved in the ongoing management of over 220 dental practices. He has over 35 years in practice management, has been a contributor to Dental Economics, Excellence in Dentistry, The Madow Brothers Audio Series and Dentaltown CE.Mr. Rossi is an ally for private independent practices in a profession increasingly impinged on by corporate dentistry and PPOs.