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Carrier Profitability Scorecard™

Sunrise Dental Group

Reporting period: March 2025 – March 2026 · 12 months

Expires Sep 14, 2026

Estimated Revenue Lost

$854,198

across 40 carriers

Total Production

$1,535,366

Total Collections

$681,168

Avg Pay Rate

44.4%

Total Adjustments

$570,054

Carrier Rankings

How each carrier compares across your practice

Carrier	Pay Rate	Revenue Lost	Classification
Delta Dental	40.6%	$488,862	RECONSIDER	⌄
Revenue Lost Breakdown Lost to Contract $364,504 Contracted rate gap Collections Gap $124,358 Contracted revenue not collected — denials, underpayments, patient balances Primary issue: contracted fee schedule. Focus renegotiation on rate increases. Share of Collections 49.0% Share of Revenue Lost 57.2% Effective Pay Rate 11.2% High dependency — this carrier represents 49.0% of collections but has a RECONSIDER classification. Consider renegotiation risk carefully.
MetLife	51.2%	$91,359	RECONSIDER	⌄

Cigna Dental	49.7%	$32,327	RECONSIDER	⌄

GEHA Dental	42.4%	$31,235	RECONSIDER	⌄

Aetna	66.8%	$18,900	MONITOR	⌄

Guardian	79.2%	$4,600	KEEP	⌄

Who Stays. Who Goes.

Summary recommendations based on your carrier mix

KEEP

Paying at or above the healthy benchmark of 75%. Maintain current contracts.

Guardian

MONITOR

Paying below the healthy benchmark of 75%. Review at next renewal.

Aetna

RECONSIDER

Paying significantly below the benchmark. Renegotiation or replacement may improve profitability.

Delta Dental · MetLife · Cigna Dental · GEHA Dental

Beyond the Rate — Hidden Costs Worth Knowing

Harder to measure, but real. These estimates show where carrier relationships cost you beyond the contract.

Administrative Burden

Carriers that generate more denials and verification work cost staff time — estimated here as a dollar value.

Carrier	Est. Admin Cost
Aetna Dental	$942
United Healthcare Dental	$1,396
Blue Shield of California	$1,088
MetLife	$4,588
Sun Life Financial	$667
Cigna Dental	$1,971
Guardian Dental	$842
Anthem Dental	$1,338
GEHA Dental	$1,375
Humana Dental	$883
Blue Cross Blue Shield	$1,017
Delta Dental	$22,363
United Concordia / Highmark	$1,071

Chair Efficiency Gap

Carriers with lower production per visit leave chair revenue unrealized — estimated here against your practice average.

Carrier	Efficiency Gap
Aetna Dental	—
United Healthcare Dental	—
Blue Shield of California	$3,708
MetLife	—
Sun Life Financial	—
Cigna Dental	$290
Guardian Dental	—
Anthem Dental	—
GEHA Dental	—
Humana Dental	—
Blue Cross Blue Shield	$4,589
Delta Dental	$32,556
United Concordia / Highmark	—

Revenue Left on the Table$854,198

Est. Administrative Impact$41,692

Chair Revenue Gap$46,480

Total Economic Impact (Selected Overlays)$942,370

Stop wondering which carriers are worth it.

Everything one PMS export gives you:

Every carrier ranked by what it actually pays you — KEEP / MONITOR / RECONSIDER
The revenue each carrier is costing you — and whether it's the rate or your billing
The hidden admin and chair-time costs beyond the contract rate
A renegotiation toolkit — letters + phone scripts, pre-filled with your numbers
All from one standard PMS export

Step 1 before you negotiate

Know where your fees stand before you touch your contracts.

Carriers cap what they pay at your UCR. If your fees are below market, even a successful negotiation leaves money on the table. The UCR Market Fee Intelligence™ report tells you exactly where you stand — code by code, zip code benchmarked.

Demo mockup · mirrors the real report's layout · representative figures, not a real practice · for review only