1047: The PPO Trap: Why More Patients Can Mean Less Money - Miranda Beeson

When PPO write-offs climb, adding more patients can increase stress while decreasing profitability. In this episode, Kirk Behrendt sits down with Miranda Beeson, ACT’s Director of Education, to unpack “the PPO trap” and explain why more patients can mean less money.

You’ll learn how to spot the effort gap, gather the right data before making insurance decisions, and shift the insurance mindset and language so your team can confidently support a more profitable model—whether that means going fully fee-for-service or reducing PPO exposure strategically. Listen to Episode 1047of The Best Practices Show!

Main Takeaways:

• More patients can increase production but still reduce profit when write-offs and effort gap widen.
• Practices should make PPO decisions with data—not emotion—by analyzing write-offs, plan mix, production, and procedure impact.
• Going fee-for-service must match your business model and requires leadership, team alignment, and consistent communication.
• If you’re not ready to go fully out-of-network, you can improve profitability by tracking write-offs per plan and participating selectively.
• Capacity matters: if you have holes in the schedule, it may not be the right time to drop plans aggressively.
• Teams must shift language from “coverage” to “benefits” and keep clinical recommendations separate from insurance limitations.
• Front office and team buy-in are critical, because inconsistent messaging and fear-based language will sabotage the transition.

Snippets:

00:00 More patients doesn’t automatically mean more profit—and why the effort gap matters.

04:59 How write-offs have grown after COVID, including practices seeing 30–55%+.

10:18 Why going fee-for-service isn’t just an insurance decision—it’s a business model and leadership decision.

14:22 The key data to review before dropping a plan (patients, production, write-offs, procedures, attrition tolerance).

18:40 How to participate strategically: track write-offs per plan, evaluate plan impact, and consider fee negotiation.

22:29 How to identify “poor fit” plans and include admin team friction (appeals, phone time, denials) in the decision.

28:05 The mindset shift: insurance as a benefit, not coverage—and why insurance shouldn’t drive diagnosis.

31:53 Language that protects the health recommendation and reduces insurance-driven conversations.

36:48 How to answer “Do you take my insurance?” without undermining value or confidence.

38:10 First steps: confirm you bill full fees, know true write-offs, and clarify your practice model direction.

Guest Bio/Guest Resources:

Miranda Beeson has over 25 years of clinical dental hygiene, front office, practice administration, and speaking experience. She is enthusiastic about communication and loves helping others find the power that words can bring to their patient interactions and practice dynamics. As a Lead Practice Coach, she is driven to create opportunities to find value in experiences and cultivate new approaches.

Miranda graduated from Old Dominion University, and enjoys spending time with her husband, Chuck, and her children, Trent, Mallory, and Cassidy. Family time is the best time, and is often spent on a golf course, a volleyball court, or spending the day boating at the beach.

Resources mentioned in this episode:

• PPO Roadmap: https://www.actdental.com/free-resources/ppo-roadmap/\
• Say This Not That: https://www.actdental.com/hubfs/Say%20This%2C%20Not%20That%20-%20Fillable.pdf
• To The Top Study Club: https://www.actdental.com/ttt/

More Helpful Links for a Better Practice & a Better Life:

• The Best Practices Show: https://www.actdental.com/podcast/
• Best Practices Association: https://www.actdental.com/bpa
• Upcoming Events & Workshops: https://www.actdental.com/events/
• Smile Source: https://www.smilesource.com/
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