The reason isn't that you're bad at running your practice — it's that no one ever taught you how to audit PPO plans individually. Your PMS shows you blended numbers. The plan that's quietly losing you $47,000 a year looks the same as the one making you money. Here's how to find it, fix it, and replace it.
It's probably not your overhead. It's not your case acceptance. It's not your marketing. For most independent practices, the answer is buried in a spreadsheet nobody ever runs: the plan-by-plan profitability of your PPO contracts.
Imagine this: one of your carriers is discounting your fees by 52%. Another by 28%. They pay on the same schedule. They look identical in your month-end report. But one of them is quietly turning every crown, cleaning, and root canal you produce on those patients into a loss after overhead. You don't see it because your PMS averages them. You've never had the breakdown. And every month you stay in that plan, the loss compounds.
A plan that costs you $4,000 a month in excess write-offs costs you $48,000 this year. $240,000 over five years. That's not "leaving money on the table." That's money you already earned — that you did the clinical work for, that your team's salary covered, that your equipment and rent produced — and then watched disappear because nobody ever showed you which plan was the culprit.
And the worst part? You'll never feel it happening. It doesn't show up as a missed payment or a bounced check. It shows up as a strange, chronic sense that the numbers should be bigger than they are.
This is the exact process we walk every practice through. It's not theory — it's the specific sequence of data, decisions, and actions that finds the leaks, plugs them, and rebuilds the revenue. Then we keep it optimized every quarter — because fee schedules drift, contracts renew, and the work is never truly done.
You enter your overhead (14 fields, 5 minutes) and import your PMS data via CSV. The audit tool classifies every PPO plan automatically based on whether each plan's net margin clears your target — KEEP, NEGOTIATE, NEGOTIATE HARD, or DROP. Drill into any plan's procedure-level breakdown for the exact CDT codes you'll use as negotiation leverage. Most owners see, for the first time, which specific plans are bleeding them — and the number is almost always larger than they guessed.
For any plan worth saving, the negotiation builder auto-fills your letter using your exact audit data — CDT fee comparison table, financial impact summary, practice value section. Adjust the requested fee % and the letter renders ready to fax or email. The built-in submission tracker auto-calculates your 15-day and 30-day follow-up dates. Most accepted negotiations land 10–25% fee increases. If a carrier holds firm on a low offer, that plan moves to termination and you already know what to do next.
This runs in parallel with your negotiations — so by the time any plan is ready to terminate, you have a concrete alternative to offer affected patients. The membership calculator lets you design tiers, model 12 months of enrollment, and produces a single breakeven number: how many members you need to fully replace dropped PPO revenue. Every member becomes monthly recurring payment direct to your practice — no claims to file, no write-offs to absorb. Most practices hit breakeven within 90 days.
For plans that can't be saved, the termination builder generates everything in one place: the carrier notice, the patient letter ready for mail merge, and seven front-desk phone scripts your team can print and use immediately. Date math is calculated for you (notice period from your contract, patient letter mail date, effective termination date). This is the part that scares most owners — but with the membership plan ready as the alternative and the communication scripts handling the conversation, retention typically lands at 70–90%.
Every 90 days, re-run the audit with fresh PMS data. The comparison dashboard surfaces what changed — fee schedule drift, classification movement, plans newly worth negotiating, your cumulative recovery since the first audit. Fee schedules drift downward over time and contracts renew on cycles you didn't choose. Catching that quarterly is the difference between this being a one-time win and a permanent operational habit. Most practices compound 2–3× their first-year recovery by year three.
You stop guessing at your numbers. You stop dreading the carrier calls. You stop watching profit disappear into a category called "write-offs" that you've never actually interrogated. Here's what's in your hands within the first week.
Enter your practice overhead, import your PMS data via CSV (Dentrix, Eaglesoft, Open Dental, and most others supported), and the tool classifies every PPO plan for you — KEEP, NEGOTIATE, NEGOTIATE HARD, or DROP — based on whether each plan's net margin clears your target. Drill into any plan for a procedure-level breakdown you'll use as negotiation leverage. Handles up to 10 plans, all formulas built in. You see the numbers your PMS has been averaging away.
Auto-fills the negotiation letter using your audit data — CDT fee comparison table, financial impact summary, practice value section. Adjust your requested fee % and the letter renders ready to fax or email. Includes a submission tracker with auto-calculated 15-day and 30-day follow-up dates. Designed to make the case so data-backed that "no" becomes harder than "yes" — most practices using this format secure 10–25% fee increases.
Design your membership tiers, set pricing, model 12 months of enrollment and MRR, and compare the math against what a PPO plan would have paid you. The output is a single breakeven number: how many members you need to fully replace the dropped PPO revenue. Tracks recurring billing platform options (Kleer, BoomCloud, Stripe, Square) and includes per-tier economics so you know which tiers are pulling their weight.
Generates the legally-sound carrier termination notice, the patient letter ready for mail merge, and seven front-desk phone scripts in one place. Computes every date for you — notice period from your contract, patient letter mail date, effective termination date. Includes a checklist so nothing slips. Termination is the step most owners fear most and avoid for years; this makes it a 30-minute task you do once and move on.
Every 90 days you re-import fresh PMS data and the comparison dashboard shows exactly what changed since your last audit — fee schedule drift, classification movement, plans newly worth negotiating, your cumulative recovery since you started. This is the part that turns a one-time profit recovery into a permanent operational habit. Without it, the leaks come back. With it, you compound.
Your 12-step operating procedure, built into a live dashboard you log into. Every step is tracked — check them off as you go, see your progress at a glance, and always know what to do next. Organized into 5 phases from data import to dollars recovered, with time estimates, clear milestones, and inline help for common issues. When you're not sure what to do next, you open the dashboard and it tells you. That's the whole point.
Yes, and honestly, sometimes more so. When you only have a few plans, it's tempting to assume they're all roughly equivalent — but the opposite tends to be true. With fewer plans, one bad contract drags down a bigger percentage of your overall PPO revenue. Practices with 2–3 plans regularly find their worst plan is costing them $30,000 to $60,000 a year. The audit takes the same 30 minutes either way. And if you only have 2–3 plans, the action plan is even simpler.
Most of our clients hadn't either. That's the whole reason this works the way it does — you don't negotiate over the phone. The negotiation builder takes your audit data and auto-fills a letter with your fee comparison table and financial impact summary, then you fax or email it. Provider relations responds in writing. Because the case is already made in the data, they either approve the increase or they don't — there's no back-and-forth conversation to be nervous about. And if you want help reviewing it before you send, that's what the 1:1 support sessions are for.
Of course you are — this is the fear that keeps most practices stuck in bad PPO contracts for years. Here's the truth that makes it manageable: patient retention during a plan drop is almost entirely determined by how you communicate the change, not by the change itself. When patients get a generic letter and nothing else, retention is maybe 50%. When they get a warm letter, a proactive phone call from your front desk, and their hygienist is prepared to reassure them at their next cleaning, retention jumps to 80–90%. The communication scripts in the toolkit handle all three. You're not leaving this to chance.
All of them. The audit tool accepts CSV exports from any modern PMS — Dentrix, Eaglesoft, Open Dental, Curve, Carestream, tab32, and others. Every modern PMS has a "Production by Insurance Carrier" report or equivalent; the tool works with the data, not the software. As long as you can export production and collections by plan, you're fine. If you get stuck finding the right report in your system, book a 1:1 and we'll find it with you on a screen share.
Week 1: you complete the audit and see, for the first time, exactly which plan is bleeding you. That insight alone is often worth the price of the program. Weeks 2–3: you send the negotiation letter (if the plan is worth saving) or the termination notice (if it's not). Weeks 4–8: you see the financial impact — lower write-offs on the remaining PPO volume, or new patients enrolling in your membership plan. Most practices recover the full program cost from the first plan adjustment within 60 days. Everything after that is pure upside.
Unlimited 1:1 screen share sessions, whenever you need them. That said — most owners don't end up using many. The software handles the heavy lifting: the audit classifies your plans automatically, the negotiation builder auto-fills your letter, the termination builder computes every date, the membership calculator does the math. The places where people used to get stuck are now automated. But when you do want a second opinion — before signing a termination notice, before counter-offering on a negotiation, while picking which plan to tackle first — book a session. Some practices use zero in their first quarter; others use three in their first month. Either is fine. You also have on-demand email support whenever you need it.
Yes. Monthly subscribers can cancel from inside your member dashboard anytime — you'll keep access through the end of your current billing cycle. Annual subscribers get a prorated refund for unused months if you cancel within the first 90 days, and a full refund at any time under the $10k Recovery Guarantee if your completed audit doesn't reveal at least $10,000 in recoverable annual profit. No retention calls, no forms to fill out, no guilt trips — we'd rather have you happy and able to come back later than locked in and resentful.
That's the whole guarantee. No deadline. No expiration window. No questions asked. Take a week to run your first audit, take six months — when it's complete, the math either shows the leak or it doesn't.
If it doesn't, you get every dollar back. If it does, you've already paid for the subscription many times over before your next quarterly check-in.
The calculator takes 2 minutes. The full audit takes 30. And the number you find will either change how you run your practice — or confirm that everything's actually fine. Either way, you deserve to know.