Find Out Exactly What Your PPO Plans Are Costing You
Most dentists know their write-off percentage. Almost none have calculated what that means in actual dollars — including the hidden administrative overhead. This tool does it in under two minutes.
A PPO profitability calculator shows the dollars a write-off percentage hides.
A PPO profitability calculator takes your fee schedule, your reimbursement rate, and your patient volume for each insurance plan, then converts that into one number: true net contribution per plan, after write-offs and administrative overhead. It answers the question a payer-mix report from Dentrix or Eaglesoft doesn't — not "what's my write-off percentage," but "what does this specific PPO plan actually put in the bank, and is it worth keeping." For a practice heading toward a sale, that same net-contribution number feeds directly into adjusted EBITDA — a buyer discounts PPO-heavy revenue differently than fee-for-service revenue, so knowing the real number before a broker does changes the negotiation.
A three-plan practice, worked start to finish.
Here's the exact math the analyzer runs, using a representative solo practice with three PPO plans.
| Plan | Gross Billed | Write-Off % | Net After Write-Off | Admin Cost (8%) | True Net Contribution |
|---|---|---|---|---|---|
| Plan A | $180,000 | 32% | $122,400 | $14,400 | $108,000 |
| Plan B | $140,000 | 24% | $106,400 | $11,200 | $95,200 |
| Plan C | $95,000 | 18% | $77,900 | $7,600 | $70,300 |
Plan A produces the most gross revenue but the least true net contribution — it's the lowest-value plan once its 32% write-off and administrative drag are counted, which makes it the first plan to exit, not the last. Total true net contribution across all three plans: $273,500 on $415,000 gross billed — a 65.9% effective collection rate, in line with the industry average the analyzer uses as its default. If this practice were heading toward a sale, a buyer's adjusted EBITDA calculation would apply roughly this same discount to PPO-heavy revenue, which is exactly why exiting Plan A before going to market, not after, is worth more at close.
PPO vs. fee-for-service vs. membership, per $100 billed.
The same $100 of billed production nets a very different amount depending on the payment model — before you even account for staff time spent on claims.
| Model | Net Collected / $100 Billed | Admin Overhead | Claim / Prior Auth Required |
|---|---|---|---|
| In-Network PPO | ~$65 | 7–12% | Yes |
| Out-of-Network Fee-for-Service | ~$85–$92 | 3–5% | Sometimes (patient-filed) |
| In-House Membership Plan | ~$95–$100 | <1% | No |
Figures are directional industry averages used as the analyzer's defaults, not a guarantee for any specific practice — run your own numbers above for an exact comparison.
The write-off column tells you a percentage.
This tool tells you the dollar truth.
The PPO Profitability Analyzer calculates your true net collection rate for each insurance plan — including write-offs and administrative overhead — then shows you what your practice would generate if you replaced that volume with membership or fee-for-service patients.
True Net Contribution Per Plan
Most payer mix reports show gross production and write-offs. This tool adds the administrative cost overlay — staff time, software, clearinghouse fees — to show what each plan actually nets your practice.
Exit Sequence Recommendation
Enter data for up to five plans and the analyzer ranks them by net contribution — giving you the exit sequence that minimizes revenue disruption and maximizes financial recovery speed.
Membership vs. PPO Comparison
Side-by-side projection: what your current PPO mix generates versus what the same patient volume generates under an in-house membership model. The difference, in real dollars, is often surprising.
When administrative costs are included, the average PPO-dependent practice collects approximately 65 cents per dollar of production. The average membership plan patient generates $1,400–$1,600 in annual practice revenue at 80–85 cents on the dollar — with near-zero administrative overhead. This tool makes that comparison specific to your practice.
Before the Analysis
After the Analysis
Four inputs. Two minutes. A clear picture.
Pull your payer mix report from your practice management software — Dentrix, Eaglesoft, or Open Dental all have one. Then enter the numbers below.
Enter Plan Data
For each PPO plan: patient count, gross production billed, and write-off percentage. Up to five plans.
Set Admin Cost Rate
Enter your estimated administrative overhead percentage — or use the default of 8%, which is typical for most practices.
Review Net Contribution
The tool calculates true net contribution per plan and ranks them from highest to lowest value.
See the Comparison
Side-by-side view: your PPO model versus the membership model at equivalent patient volume.
PPO Profitability Analyzer
Enter your plan data below. No email required — your numbers stay in your browser and are never collected or stored.
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The numbers told you the story.
Now get the playbook.
The PPO Profitability Analyzer is the diagnostic. The Insurance-Free Dental Practice is the treatment plan — a complete step-by-step guide to designing your membership plan, exiting your contracts professionally, and building the practice that collects 95 cents on every dollar.
The Book
10 chapters covering the full arc: Pre-Exit Audit → Plan Design → Contract Exit → Marketing → Operations → Scaling. Available on Amazon and Kajabi.
Calculator Suite
9-tab Excel workbook with 231 live formulas — attrition modeling, cash flow bridge, KPI tracker, and the full membership revenue projector.
3-Part Webinar Course
Three one-hour sessions covering the case for freedom, the exit strategy and plan design, and marketing and operations. Includes a full presenter script.
Ready to stop leaving money on the table?
The Insurance-Free Practice Suite has everything you need — the book, the calculators, and the course — to make the transition with confidence.
Questions dentists ask about PPO profitability
Your true net contribution per PPO plan — write-offs plus an administrative overhead overlay for staff time, software, and clearinghouse fees — then ranks your plans from most to least valuable and compares that total against an equivalent membership-plan scenario.
Most PPO-dependent practices collect roughly 65 cents per dollar of production once administrative overhead is included, even though the headline write-off percentage on a fee schedule often looks smaller than that.
No. Dropping several high-volume plans simultaneously is a cash-flow event, not a strategy. The practices that transition successfully treat it as an 18–36 month project: exit the lowest-margin plans first, build a membership plan, and give the revenue bridge time to close.
You set the fee, you keep the full amount, and there's no claim, prior authorization, or write-off. Membership patients also tend to accept treatment at a meaningfully higher rate than insurance-dependent patients, because they're financially committed to the practice rather than to a network.
No. The analyzer runs entirely in your browser — nothing you enter is collected, saved, or transmitted.
That's the most common outcome, and it's a perfectly good one. The tool's exit-sequence ranking works the same way whether you're dropping one underperforming plan or restructuring your entire payer mix — start with whichever plan ranks lowest on net contribution.
Keep reading
- How to Run a PPO Profitability Analysis on Your Own Practice — the four numbers behind this calculator
- How to Go Insurance-Free — the full practice transition framework
- How to Exit Your PPO Contracts Without Losing Patients — the patient retention playbook
- What Is a Good PPO Write-Off Rate? — benchmark data across the industry
