Letting Go To Grow: Why It’s Okay To Move On from PPO Patients

Let’s get one thing straight: your dental practice is a business, not a charity. And in today’s climate of rising overhead, stagnant reimbursements, and increased complexity in patient care, it’s time for dentists to stop feeling guilty about letting go of patients who are deeply dependent on PPO insurance. While this may feel counterintuitive—especially for those who entered dentistry to help people—choosing to transition away from low-margin, PPO-driven care can actually lead to better patient outcomes, a healthier team culture, and a more sustainable business.

 

PPO participation often comes with invisible handcuffs. You’re expected to deliver high-quality, comprehensive care while being reimbursed at rates that haven’t kept pace with inflation—or the rising costs of running a practice. Many dentists spend hours navigating claim rejections, pre-authorizations, and delayed payments, only to realize their margins are razor-thin.

📉 Consider this:

• PPO plans often result in 30–50% write-offs from your standard fees

• You’re doing the same (or more) work for a fraction of your value

• Administrative burdens increase as insurance complexities grow

Here’s the uncomfortable truth: not every patient is the right fit for your practice. If you’re constantly under pressure to fill your schedule with high-volume, low-margin procedures just to stay afloat, your quality of care—and life—suffers. By “firing” PPO-dependent patients (or, more accurately, transitioning them out of your practice), you’re not abandoning people. You’re making room for those who value your time, skill, and the personalized experience your team delivers.

🦷 What PPO-dependent patients often bring:

• Hesitancy to accept treatment not fully covered

• Pressure to “fit in” care within limited insurance allowances

• Resistance to long-term or comprehensive treatment plans

• Disruption to your schedule with last-minute cancellations or low commitment

Think about the patients who drain your resources: the ones who only come in when insurance allows, question every treatment recommendation, or decline necessary care unless it's 100% covered. Now imagine a practice filled with patients who trust your expertise, invest in their health, and return because of the value—not the cost.

💡 These high-quality patients:

• Accept treatment based on trust and education, not just insurance approval

• Prioritize long-term oral health and preventive care

• Respect your time and your team

• Often refer like-minded friends and family

Making the shift away from PPOs doesn’t have to be abrupt or cold. You can strategically phase out plans, communicate with clarity and empathy, and refer patients elsewhere if necessary.

📅 A phased approach might include:

• Reviewing and identifying your lowest-reimbursing PPOs

• Creating a script for team members to explain the change to patients

• Offering in-house membership plans as an alternative

• Reinvesting freed-up time into marketing, CE, or fee-for-service enhancements

Dentists often carry a caregiver’s guilt—but remember: boundaries are not unkind. They are essential. Releasing patients who are no longer aligned with your vision allows you to focus on those who are—and that benefits everyone. You’ll have more time for comprehensive treatment, more flexibility for continuing education, and more energy to lead a practice that reflects your values.

The reality is this: you didn’t go to dental school to be micromanaged by insurance companies. You went to serve patients with excellence.

🚀 Letting go of PPO-dependent patients isn’t giving up. It’s leveling up.