When to Reconsider or Drop a PPO Contract

By CovalentGPO | December 19, 2024

Every PPO relationship starts with good intentions — more patients, more growth, more stability.
But sometimes, that same PPO can start to hurt your business more than it helps.

Knowing when to reconsider or even drop a PPO contract is part of running a healthy, sustainable private practice.

1. Recognize the Warning Signs

Certain indicators suggest a PPO may no longer be a good fit:

  • You’re working harder but collecting less each month
  • Administrative burdens are rising (claim rejections, downgrades, delays)
  • Reimbursements haven’t kept pace with inflation or cost of supplies
  • The network restricts your ability to use preferred labs, materials, or vendors

When these issues outweigh the benefits of patient flow, it’s time to review your contract terms.

2. Do the Math Before Making a Move

Before dropping a PPO, analyze:

  • What percentage of total revenue the PPO contributes
  • What your true net income is after write-offs
  • How many of those patients are truly loyal to you versus the insurance

Often, a small percentage of low-margin plans can consume an outsized amount of your time and staff energy.

3. Prepare Your Team and Patients

If you decide to exit, plan a thoughtful transition:

  • Notify the carrier according to contract timelines
  • Communicate with patients clearly and early — emphasize that you still accept their insurance out-of-network
  • Train your front desk on how to present the change positively and explain continued access to care

Transparency builds trust and keeps more patients than you might expect.

4. Strengthen Other Revenue Streams

As you scale back on certain PPOs, look for opportunities to:

  • Introduce an in-house membership plan
  • Expand elective and cosmetic services
  • Improve case acceptance through patient financing
  • Optimize your fee-for-service collections

Reducing dependence on PPOs doesn’t mean reducing care — it means regaining control of your business.

5. Lean on Your Network

If you’re unsure how to start or want examples of successful transitions, reach out to the Covalent Dental Partners community.
Our members share real-world experiences, templates, and strategies for making smart PPO decisions without jeopardizing patient relationships.

Dropping a PPO isn’t a failure — it’s a strategic decision.
With preparation, communication, and community support, it can lead to stronger finances and renewed professional freedom.

At Covalent Dental Partners, we’re here to help private practices stay independent, informed, and empowered.

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