Let’s be honest. Nothing derails a perfectly good clinical day faster than a claim rejection. Whether you are a hygienist trying to justify SRP, a dentist reviewing a treatment plan that does not match a patient’s coverage, or an office manager knee deep in a stack of unpaid claims, insurance has a way of inserting itself into every corner of the practice. And while each role experiences insurance differently, dentists, hygienists, and administrative teams are connected by the same challenge. If the practice does not get reimbursed, everybody feels the impact.
That is exactly why I spoke with Angela Holland, CEO of Preferred Dental Solutions and one of dentistry’s most respected voices on PPO strategy, coding, and reimbursement. Angela has helped offices around the country recover lost revenue by improving systems, training teams, and tightening documentation. I started by asking her to level set where things stand today for the entire care team, not just dentists.
Q: Many dentists feel stuck when it comes to navigating PPOs. What are the most common mistakes you see practices making with their PPO network setup?
Angela Holland: The most common mistake I see practices make with PPOs is adopting a “more is better” mindset, assuming that signing up with more networks will automatically bring in more patients. In reality, PPOs often work against each other. Due to most favored nations clauses and third-party access to direct contracts, reimbursements are frequently reduced to the lowest fee schedule.
Too often, dentists sign contracts placed in front of them without fully understanding the downstream impact. This can lead to being locked into networks that do not serve the practice, or overlapping agreements that unknowingly grant payors access to the lowest possible fees.
Another costly mistake is waiting until credentialing becomes urgent. Without a strategy from the start, practices end up with a patchwork of contracts that makes long term profitability harder to achieve.
That is why I say this with confidence. Having a true insurance expert guiding your PPO decisions is no longer a luxury, it is a necessity for growth and sustainability.
Q: Your company, Preferred Dental Solutions, focuses on moving doctors from reactive to strategic. What does a truly strategic PPO setup look like in practice?
Holland: A strategic PPO setup means every contract is intentional. It is not about signing up for as many or as few plans as possible. It is about selecting the right mix that supports your practice goals, your patient demographics, and your long-term profitability. A true strategy also considers exit plans, or how you will opt out of low paying networks when they no longer serve you. In short, less is more, and smart, selective participation creates leverage and sustainability. Also, making sure the PPOs work for the doctor so the doctor is not working for the PPO. This means they reimburse promptly, you can contact a representative, and there is future negotiation ability.
Q: You often say that revenue cycle management actually begins with PPO strategy. Can you explain how the choices dentists make on the front end directly impact collections and profitability later?
Holland: This statement is so true. Revenue cycle management really begins with the contracts you sign. If you are locked into low reimbursements on the front end, no amount of billing efficiency will fix the profitability problem. On the flip side, when PPO participation is set up strategically, collections become smoother, reimbursement is stronger, and your team spends less time chasing money. Credentialing and negotiations are the foundation of healthy RCM. It is where the money story begins.
This is where every member of the team matters. Hygienists, assistants, treatment coordinators, front office staff, and dentists all influence claim outcomes through chart notes, diagnostic support, documentation, claim submission accuracy, and follow up. Everyone is connected to the revenue cycle, whether they realize it or not.
Q: What are some practical strategies dentists can use to optimize their PPO participation so that it works in favor of the practice rather than against it?
Holland: Sure, some of the best tips I can give include the following:
Review and update your UCR fees annually to stay in the 80th to 90th percentile.
Actively renegotiate PPO fees with an expert every two years.
Always submit UCR fees on claims. Do not assume it is being done. Double check your claims. This allows for optimal reimbursement and for negotiations every two years.
Partner with experts who understand the fine print and can protect you from traps like most -favored nations clauses or third parties accessing direct contract fees.
Optimization is about being proactive rather than reactive. Your PPOs should be working for you, not the other way around.
Q: Where do you typically see the biggest profit leaks in PPO contracts, and how can practices plug those leaks?
Holland: The biggest profit leaks I see are from overlapping agreements and not properly opting out. Doctors unknowingly give access to their lowest fee schedule across multiple payors, and it eats into profitability with every claim. Also, the Most Favored Nations clause is something most people are not aware of. Plugging these leaks requires careful contract review, strategic network selection, and regular fee negotiations or network optimization to keep your practice aligned with market rates.
Q: Can you share a success story where a practice restructured their PPO participation and saw measurable improvements in profitability or growth?
Holland: I would love to share a specific success story with you. Not to brag, but we offer a money-back guarantee, so 100 percent of our clients are truly success stories. A specific scenario I can think of is Dr. Ben Sirrine, who acquired a practice, and we increased his top payors from what the seller had by 46 percent, resulting in more equity in his new practice literally from the beginning. Another client is Dr. Eric Christensen, who had many plans accessing his lower UCCI fee schedule. We negotiated and optimized his PPOs by over 56 percent. I could go on and on with stories just like these. We stand behind our guarantee and make the PPOs work for the practice.
Q: How much room is there really to negotiate PPO fees, and what advice do you give dentists who feel powerless in those negotiations?
Holland: There is usually more room to negotiate than dentists realize, but you have to know how to approach it. The way we generate more revenue is not always through direct negotiations. It is a combination of direct negotiations, opt outs, moving networks, and dropping the networks not serving you. With the right expertise, you can create measurable improvements in your fee schedules and networking and even create a better life not having to work so hard for so little. Think about the same patients, the same codes, much more money. When a practice negotiates their own fees, on average they are increasing fees by 1 to 7 percent. We increase on average by 28 percent.
Q: What role does technology and data analysis play in making smarter decisions about PPOs and overall revenue cycle management?
Holland: Data is everything. You cannot make smart decisions about PPOs without knowing where your patients are coming from, how much you are collecting per plan, and how each network impacts profitability. Technology allows us to model scenarios. For example, what happens if you drop a certain plan or renegotiate a fee schedule. The numbers tell the story, and when you combine that with strategic expertise, you can make confident and data driven, profitable decisions.
Q: You are leading a movement to get PPOs working for doctors instead of the other way around. If you could give dentists one piece of advice, perhaps where to start, what would it be?
Holland: If I could give dentists one piece of advice, it would be this. Do not treat PPOs as the enemy. They can be one of the biggest drivers of your financial success or your financial frustration. Start by reviewing your current network participation. Where are you overextended, and where are you under leveraged. Are plans paying based on fee schedules you should be receiving? Why not. Strategic PPO management is not a luxury, it is the backbone of a profitable, thriving practice. Oh, and one more piece of advice just to make sure you are remembering this. Always be sure you are submitting claims with UCR fees listed.
Q: If you had one piece of advice for dentists who want to shift from stuck to truly strategic in 2026 and beyond, what would it be?
Holland: For 2026 and beyond, my advice is this. Make PPO reviews a regular part of your business strategy and do not try to navigate it alone. Networks shift constantly, as do employer groups, and the difference between thriving and just getting by often comes down to having an expert in your corner who understands how to leverage those changes.
When you lean into experts who live and breathe PPO strategy, you free yourself from the guesswork and frustration of trying to manage it on your own. Instead, you gain clarity, stronger reimbursements, and the confidence that your practice is set up to win. With the right guidance, PPOs stop being a source of stress and start fueling both profitability and freedom. With this recipe, you will not only succeed, you will build a practice that thrives with abundance.
After speaking with Angela, the message is clear. Dental insurance is not just a dentist issue. It affects the clinical side and the business side. Hygienists documenting perio and preventive care need to understand how their notes support profitable claims. Office managers and administrative staff need systems that prevent denials instead of reacting to them. Dentists need contracts that support long-term success. This is information every hygienist, dentist, and office manager must be armed with because working in dentistry today means working with insurance. Practices deserve to be paid for the care they provide. Patients deserve clarity. And every member of the dental team deserves a workflow that supports both.
About the author
Melissa K. Turner is a dental industry brand strategist, healthcare innovation advisor, and clinical thought leader specializing in saliva, the oral microbiome, and clinical technology. She designs influence systems that shape how innovation earns trust and adoption across dentistry and healthcare. Turner is the co-founder of The Denobi Awards and the National Mobile & Teledentistry Conference, and the creator of the HALO System™ (Human + AI Leadership Optimization). Her work bridges clinical insight, brand strategy, and emerging technology to help organizations and leaders build credibility in an AI-driven world. To become XPERT Certified or receive your free downloadable xerostomia protocol, contact hello@melissakturner.com. Click here to subscribe to Melissa’s new weekly LinkedIn newsletter, The Future of Dentistry Report.
