How to Fix Your Dental Fees and PPO Contracts: 6 Options, Honestly Compared You already suspect it: your fees haven't kept pace with your costs, and a few carriers are quietly costing you more than they're worth. The question isn't whether to fix it — it's how. There are six realistic ways to get an accurate, code-by-code read of where your fees and carriers actually stand and then act on it, and they are not equal on time, cost, or whether you end up with something you can actually use. Here's the honest version of each. The goal is the same in every case: see where your fees sit against your local market and which carriers are worth keeping — then raise fees and renegotiate from strength. The options differ wildly in effort, cost, and whether you finish with a plan or just more data. The most expensive option is the one most practices pick by default: doing nothing. The bleed is silent, but it compounds every year the schedule sits untouched. Buying reports gets you data; a consultant gets you done-for-you at a cost that scales per carrier; the gap in the middle — all your data, turned into one sequenced plan, that you own — is the one most practices never find. What are you actually trying to achieve? Strip away the tactics and every owner-dentist wants the same three things: to know whether their fees are below their local market (by code, not by gut), to know which carriers are dragging on the bottom line, and to fix both in the right order — raise fees to a defensible level first, then renegotiate the worst contracts from strength. Every option below is just a different way to get there. Judge each one on four things: how much of your time it eats, what it really costs, how much expertise it demands of you, and whether you end up holding an actionable plan or just a pile of numbers. The most expensive option isn't the consultant. It's the one most practices choose by default — doing nothing — because its price never shows up on an invoice. Option 1 — Do nothing (the default) This is the option most practices are actually on, usually without deciding to be. The schedule you set years ago keeps running; the write-offs you've never itemized keep accruing; the carrier that pays 40% below the others keeps getting your chair time. Nothing breaks, so nothing prompts action. The cost is real but invisible: a fee schedule frozen while your costs climbed is lower in real terms every year, and across a full book of patients that under-pricing compounds quietly. You can't fix what you've never measured — and "later" has a price tag that doesn't appear until you finally add it up. 30–40% the share of full-fee production participating PPO practices write off, per the ADA's 2023 Dental Fees Survey (higher in competitive metros) — the silent bleed every option below is trying to stop, and a gap to work toward, not a number guaranteed to come back Option 2 — Delegate it to your CPA or a staff member The natural instinct: "I'll have my accountant or office manager look into it." It feels like progress, and it's better than ignoring the problem — but it usually stalls at the same place, for a specific reason. Your CPA sees your profit-and-loss in totals — they can tell you collections are soft, not that your D2740 sits at the 40th percentile for your ZIP or that one carrier accounts for a disproportionate share of your write-offs. Your front-desk team lives in the day-to-day claims but rarely has benchmark data or the time to build the analysis. Neither is the wrong person; it's the wrong tool for the question. You end up with concern, not a code-by-code answer. Option 3 — Do it yourself, from scratch You can do all of this yourself. Pull the production and adjustment exports from your PMS, find current fee-benchmark data for your area, build the spreadsheets, calculate your percentile position code by code, rank your write-offs by carrier, and interpret the results into a plan. Owner-dentists who love a spreadsheet have done it. Be honest about the cost, though: it's a real learning curve and a meaningful chunk of evenings, the benchmark data is the hard part to source well, and small errors in how you map procedures or read the numbers quietly produce wrong conclusions. For a tiny, single-carrier book, DIY can genuinely be enough. For most practices, it's a second job you'll start, half-finish, and set aside. Option 4 — Buy reports from separate vendors A step up from a blank spreadsheet: buy a fee-survey report from one source, maybe a write-off or coding report from another. Now you have professional-grade numbers instead of guesses. This is a legitimate option and a better starting point. But it's still roughly square one-and-a-half. A fee survey tells you where your fees sit; it doesn't tell you which carriers to renegotiate first, in what order, or hand you the case to do it. You've bought data, not a decision — and stitching disparate reports into one coherent plan is exactly the work that stops most practices cold. You're better informed and still not moving. Option 5 — Hire a consultant to do it for you Bring in a PPO-negotiation or fee consultant and you get genuine expertise and a done-for-you result — the strongest version of "someone else handles it." For a complex situation, or if you simply want it off your plate and the math pencils out, this can be worth it. The honest part is the cost structure, because the headline numbers mislead. Consultants offer different models — they charge per carrier ($1,400 or more for a single carrier's negotiation), on contingency (an ongoing percentage of whatever they recover), on a monthly retainer (ExecTech, for example, publishes roughly $3,400–4,800 a month), or as a done-for-you package (Veritas' enrollment runs about $5,995). However it's structured, the real number scales with the size of your book: a practice with several negotiable carriers isn't looking at one $1,400 fee — it can climb well into five figures. And when it's over, the capability leaves with the consultant; you don't keep it. Option 6 — Igion This is the gap in the middle of that list: the consultant's homework — your full data turned into one sequenced plan — productized so you can do it yourself, and own it. You upload one standard PMS export (PII stripped at upload; no patient data stored), and you get a plain-English read of where each fee sits against gold-standard, federal-grade, public-domain, carrier-bias-free benchmark data, modeled to your ZIP, your carriers ranked KEEP / MONITOR / RECONSIDER, and the two sequenced into one plan: raise fees to a defensible level first, then renegotiate the worst carriers from strength — with the letters and submission pack ready to send. One flat price covers your whole book: UCR Market Fee Intelligence™ ($99) for the fee side, the Carrier Profitability Scorecard™ ($149) for the carrier side, or the Practice Intelligence Bundle / "The Practice Playbook" ($199) that combines both in the right order. Same honesty as everywhere else on this page: the gap between your fees and what you collect is a ceiling to work toward, not money guaranteed to land — and on a fully-capped PPO book, raising fees is the enabler for renegotiation, not an automatic raise. The six options at a glance Option Real cost Your effort End with a plan? Do nothing Invisible, compounding None No CPA / staff Their time Low–medium No — totals, not specifics DIY from scratch Your time High Maybe, if you're rigorous Buy reports Per report Medium No — data, not a plan Consultant Per carrier / % / retainer Low Yes — but you don't keep it Igion $99–199, whole book Upload one file Yes — and you own it So which is right for you? If you have a single carrier and genuinely enjoy the spreadsheet work, DIY is defensible. If your situation is unusually complex and you want it fully off your plate — and the per-carrier or retainer cost pencils out — a consultant can be the right call, and there's no shame in paying for done-for-you. For most family and general practices, though, the honest sweet spot is the missing middle: the full analysis and the sequenced plan, accurate and yours to keep, without a five-figure invoice that scales every time you add a carrier. Frequently asked questions Should I hire a PPO negotiation consultant? It depends on complexity and how much you value done-for-you. A consultant brings real expertise, but you typically pay per carrier, on contingency, or on a monthly retainer — so the cost scales with the size of your book, and the capability leaves when they do. For a complex book you want fully handled, it can be worth it. For most practices, a productized tool gets you the same underlying homework — your data, benchmarked and sequenced — for a fraction of the cost, and you keep it. Can I benchmark my fees and renegotiate my PPOs myself? Yes. The two hard parts are sourcing good, geographically accurate benchmark data and turning the numbers into the right sequence of actions — raise fees to a defensible level first, then renegotiate from strength. That's the work, whether you do it by hand or use a tool that does it for you. Do fee-benchmark reports tell me what to do? No. A fee survey or write-off report gives you data — where your fees sit, what you're writing off. It doesn't rank which carriers to renegotiate first or hand you the case to do it. That gap between data and a decision is where most practices stall. What's the least expensive way to actually see my fee and carrier problems? A productized analysis is the cheapest path that ends in an actual plan rather than raw numbers. DIY is "free" only if your time is free and your analysis is correct; buying separate reports costs more than it looks once you add them up and still leaves you to connect them; consultants are the most expensive by an order of magnitude on a multi-carrier book. See where you actually stand You don't have to guess, and you don't have to choose between a spreadsheet and a five-figure invoice. Igion turns one PMS export into a plain-English read of your fees against gold-standard, federal-grade, public-domain, carrier-bias-free benchmark data, modeled to your ZIP, your carriers ranked KEEP / MONITOR / RECONSIDER, and one sequenced plan — fees first, then renegotiate from strength. See pricing · see a sample UCR report · see a sample Carrier Scorecard · or read how to tell if your fees are too low, why you raise fees before renegotiating, and which carriers are worth keeping.