"The decision we make now does not have to be forever."
Connect With Our Sponsors
Solventum - https://go.solventum.com/clarity
GreyFinch - https://greyfinch.com/jillallen/
A-Dec - https://www.a-dec.com/orthodontics
SmileSuite - https://getsmilesuite.com/
Summary
On this Just Jill episode of the Hey Docs! Podcast, Jill Allen breaks down how orthodontic practices should evaluate going in-network versus staying out-of-network with insurance. She explains the difference between credentialing and simply registering, notes that fee negotiation is often limited and that older “grandfathered” fee schedules may not transfer in acquisitions, and emphasizes that the right choice depends on location, demographics, competition, and practice vision. Jill frames PPO write-offs as a recurring marketing expense and encourages startups to treat network participation as a flexible lever rather than a permanent decision, while established practices should audit write-offs against true insurance-driven referrals to find “low-hanging fruit.” She also clarifies that out-of-network practices can still bill benefits, sometimes with payments sent to patients, and stresses the need for team training on benefits, EOBs, and plan variability.
Connect With Our Guest
Jill Allen & Associates - https://www.practiceresults.com/
Takeaways
Chapters
00:00 Introduction
03:00 Startup Practices Overview
07:52 Pros and Cons Factors
08:56 Pivoting Your Decision
10:28 Write Offs as Marketing
13:45 Out of Network Myths
19:11 Homework and Market Research
23:48 Acquisitions and Established Practices
30:52 Team Training and Systems
36:50 Key Takeaways and Wrap Up
Episode Credits:
Hosted by Jill Allen
Produced by Jordann Killion
Audio Engineering by Garrett Lucero
Are you ready to start a practice of your own? Do you need a fresh set of eyes or some advice in your existing practice?
Reach out to me- www.practiceresults.com.
If you like what we are doing here on Hey Docs! and want to hear more of this awesome content, give us a 5-star Rating on your preferred listening platform and subscribe to our show so you never miss an episode.
New episodes drop every Thursday!
Connect With Our Sponsors
Solventum - https://go.solventum.com/clarity
GreyFinch - https://greyfinch.com/jillallen/
A-Dec - https://www.a-dec.com/orthodontics
SmileSuite - https://getsmilesuite.com/
Summary
On this Just Jill episode of the Hey Docs! Podcast, Jill Allen breaks down how orthodontic practices should evaluate going in-network versus staying out-of-network with insurance. She explains the difference between credentialing and simply registering, notes that fee negotiation is often limited and that older “grandfathered” fee schedules may not transfer in acquisitions, and emphasizes that the right choice depends on location, demographics, competition, and practice vision. Jill frames PPO write-offs as a recurring marketing expense and encourages startups to treat network participation as a flexible lever rather than a permanent decision, while established practices should audit write-offs against true insurance-driven referrals to find “low-hanging fruit.” She also clarifies that out-of-network practices can still bill benefits, sometimes with payments sent to patients, and stresses the need for team training on benefits, EOBs, and plan variability.
Connect With Our Guest
Jill Allen & Associates - https://www.practiceresults.com/
Takeaways
- Being in-network can help attract patients but comes with costs.
- Established practices may find the costs of being in-network outweigh the benefits.
- The decision to go in or out of network should be based on individual practice goals.
- Insurance write-offs can be viewed as a marketing expense.
- Startups can pivot their insurance decisions as their practice evolves.
- Understanding local competition is crucial for insurance decisions.
- Insurance participation should be evaluated regularly, not just once.
- Out-of-network practices can still bill for patient insurance benefits.
- Training staff on insurance processes is essential for success.
Chapters
00:00 Introduction
03:00 Startup Practices Overview
07:52 Pros and Cons Factors
08:56 Pivoting Your Decision
10:28 Write Offs as Marketing
13:45 Out of Network Myths
19:11 Homework and Market Research
23:48 Acquisitions and Established Practices
30:52 Team Training and Systems
36:50 Key Takeaways and Wrap Up
Episode Credits:
Hosted by Jill Allen
Produced by Jordann Killion
Audio Engineering by Garrett Lucero
Are you ready to start a practice of your own? Do you need a fresh set of eyes or some advice in your existing practice?
Reach out to me- www.practiceresults.com.
If you like what we are doing here on Hey Docs! and want to hear more of this awesome content, give us a 5-star Rating on your preferred listening platform and subscribe to our show so you never miss an episode.
New episodes drop every Thursday!
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