Understanding PPO Contracts, Policies and More:

This is a follow-up course to the presentation given by Dennis McHugh, ADA manager for third party payer advocacy back in January 2020. Many dentists sign PPO provider contracts without actually crunching the financial numbers to determine if it is a good fit for the practice. This presentation will show dentists how to do the math and how to evaluate the financial implications of signing or not signing a PPO participating provider agreement. This presentation will once again review the most common contractual clauses within third-party payer contracts and their potential financial implications on a dental practice. In addition, an update on the current dental benefits marketplace will be provided. Topics for discussion include:

• How to do the "math" when evaluating a participating provider agreement
• Reviewing current participating provider agreements
• Learn about common contractual clauses within third-party payer contracts and their potential financial implications on a dental practice
• Learn about available ADA resources to help your practice succeed

This presentation is the latest in a series of educational programs for dentists and their practice staff whose focus is assisting patients presenting with PPO dental plans. It is designed for dentists and front office staff trying to navigate the dental benefits field. We look forward to your participation.

Learning Objectives

Upon completion, participants will have a better understanding of common contractual clauses within third-party payer contracts and the potential financial implications on a dental practice.

Upon completion, participants will learn how to successfully crunch the PPO financials so that dentists can make informed decisions on PPO plan participation.

Upon completion, participants will gain an understanding of what questions to ask before signing an agreement, will learn of available ADA resources and how to receive one-on-one assistance from the ADA.

  • CE Credit: 1
  • Audience:
Dennis McHugh

Dennis McHugh

Dennis McHugh is the manager of third party payer advocacy for the American Dental Association and works in the Practice Institute’s Center for Dental Benefits, Coding and Quality (CDBCQ). CDBCQ is the ADA agency responsible for promoting resources and informaton on dental benefit plans to employers and member dentists. In addition, CDBCQ responds to requests and helps resolve problems from member dentists regarding concerns with third party payers and the CDT Code. He has been with the ADA for 20 years and prior to that spent 7 years working for the American Association of Orthodontists. Dennis graduated from Southeast Missouri State University with a Bachelor of Science degree in Business Administration and an Associate of Applied Science in Computer Science.