An affordable outsourced solution for managing PPO Contracts.

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1 Patient Messaging Revenue Strategy Development Contract Negotiation An affordable outsourced solution for managing PPO Contracts. PPO Management Process Ready to START? Schedule a free consultation with Unitas Dental: Clinical Support Participation Optimization 1 Visit our website at UnitasDental.com 2 Click on the Schedule a Consultation button Credentialing & Compliance 3 Select a date and time that will work best for you Starting at: $399/Month One-time Setup Fee: $799 Revenue Strategy Development Contract Negotiation Participation Optimization We evaluate your current office fees and assist you in setting your fees at a competitive level. We help you understand how your office fees may affect PPO reimbursements and how to plan your participation in order to achieve your revenue goals. Credentialing Services We negotiate with insurance companies in an effort to raise your PPO reimbursement fee schedules. We focus on your practice s top grossing procedural codes so that successful negotiations result in maximum revenue gains. Clinical Support We confirm your current insurance participation and analyze alternative ways for you to participate. Optimization may allow your practice to see a greater number of patients in-network, and at higher levels of reimbursement. Patient Messaging Credentialing can be tedious and time consuming. It is, however, necessary to contract with PPO insurance and to remain compliant. We complete credentialing applications or re-credentialing forms on your behalf so you can focus on patient care. We can provide expertise and guidance in many areas that commonly lead to delay in payment and non-payment. We can help you trouble-shoot billing issues, handle denials, coding issues, cross-coding, appeals, focus reviews and audits. It is important for your patients to understand how you participate with insurance and the changes being implemented by their dental insurance providers. We can provide you with patient communication materials to inform and educate your patients on PPO insurance and patient benefit issues.

2 Revenue Strategy Development Strategy, by definition, is a plan of action or policy designed to achieve a major or overall goal. Our overall goal in working with you is to increase revenue generated from your PPO insurance contracts. We believe that one of the first steps in developing an effective revenue strategy is to evaluate and set your UCRs (office fees) at a competitive level. Office UCRs Lowest Fees Competitive Fees The graph to the left illustrates a dental practice s UCRs (office fees) compared on a percentile basis to both the lowest and most competitive fees in a specific geographic area. Raising your office fees can generate more revenue per fee-for-service patient and can improve the potential to negotiate higher insurance reimbursements. You control where to set your fees and we can provide the data and expertise to help you make an informed business decision. The next steps in developing your PPO revenue strategy involve mapping your current or potential PPO participation, determining if your current PPO fee schedule(s) are eligibe for negotiations and identifying opportunities to optimize your PPO participation. We prepare and provide to you a Insurance Roadmap listing your current PPO and Network participation status. We will update your Roadmap with the status of negotiations, when you add or terminate participation or if your participation otherwise changes.

3 Contract Negotiation We negotiate with insurance companies in an effort to raise your PPO reimbursement fee schedules. We focus on your practice s top grossing procedural codes so that successful negotiations result in maximum revenue gains. Your Unitas team will work hard to negotiate with the insurance companies you are contracted with or negotiate fee schedule proposals that may be beneficial for you to contract with. Participation Optimization We confirm your current insurance participation ( Roadmap ), whether through direct insurance contracts or Networks, and identify any alternative ways for you to participate ( Optimization ). Networks and Leased Panel sharing can be complex and the relationships between insurance companies and Networks regularly change but we attempt to keep up with these changes through our continuous work with national PPO insurance companies, Networks and dental offices throughout the nation. Optimization may allow your practice to see a greater number of patients in-network, and at higher levels of reimbursement. Negotiations and optimization can take time and we will keep you updated on our progress. Upon completion of successful negotiations or optimization of an insurance contract, we provide to you a report showing the potential increase in revenue. An example of this report is shown to the right. TOP GROSSING CODES UCRs FS #1 FS #2 Current Negotiated Increase PPO #3 Dollar Gain Percentage Increase *Increased Revenue 120 $3 13% $ $3 23% $ $3 14% $ $5 8% $ $3 7% $ $3 9% $ $3 0% $30 *Increased Revenue Total $6,030 + Anytown, USA

4 Credentialing Services Credentialing can be tedious and time consuming. It is, however, necessary to contract with PPO insurance and to remain compliant. We will maintain your current office information, dental provider information, credentials, and other information necessary to complete credentialing applications and re-credentialing forms. Your Unitas team will complete credentialing applications or re-credentialing forms on your behalf. Once completed, we will provide you with the applications and insurance contact to whom you can submit your credentialing applications. This can free up valuable time for office staff to focus on patient care and other tasks that are more important to your practice. NOTE: The time frame for insurance companies to process credentialing applications varies and, in some cases, can take up to four (4) months or longer. We cannot control the time it takes for insurance companies to process applications and provide effective dates.

5 Clinical Support Unitas can provide expertise and guidance in many areas that commonly lead to delay in payment and non-payment. We can help you trouble-shoot billing issues and handle denials, coding issues, cross-coding, appeals, focus reviews and audits. Problems that prevent or delay adjudication can be complex and require analysis of the coding, narratives, or potential missing information. According to the National Association of Dental Plans, Insurance payors process more than 250 million claims annually. Seventy percent (70%) are analyzed using computerized decision logic based on the contract provisions of the patient s policy and are auto-adjudicated ( paid ). Thirty percent (30%), however, are removed from the auto-adjudication system and transferred to a dental reviewer. These claims are often denied or payment thereof delayed. You may then be forced to spend time identifying the issue and determining whether to submit additional information. Understanding these problems can be time consuming and require expertise or research. Our Clinical Support team has over 40 years of combined dental experience and includes ADCA certified coders who works regularly with insurance companies to understand and stay current on insurance billing issues. While we do not submit or resubmit claims on your behalf, we can be a source of knowledge and provide industry expertise to assist you in resolving claim related issues.

6 Patient Messaging It is important for your patients to understand how you participate with insurance and the changes being implemented by their dental insurance providers. We can, from time to time, provide you with patient communication materials to inform and educate your patients on PPO insurance and patient benefit issues. The dental insurance industry continues to change and these changes affect you and your insurance patients. We strive to keep you informed of these changes and help you explain these changes to your patients when necessary. For example, one major insurance company recently gave written notice to all its participating Dentists that it intended to implement a Cost Effectiveness Program for its insured customers. This Program designated its network Dentists as one, two or three star Dentists and left room for patients to misunderstand the meaning of the designation and whether to remain a patient of their current Dentist. In response, we provided sample patient messaging for Dentists to use to educate their patients on this issue, to help their patients understand this specific insurance company s strategy, to explain this insurance company s Program is not an obstacle to continue as their patient, and to reiterate the Dentist s primary concern is their patients oral health and providing quality dental care.