20+ years on the carrier side
We know how carriers evaluate fee increase requests, who makes the decision, and what creates real leverage, because we spent more than two decades inside some of the largest carriers in the country.
Fee schedule negotiations for DSOs and independent dentists
We negotiate your commercial fee schedules carrier by carrier, led by a team that spent 20+ years on the carrier side of the table. Same patients, same procedures, same overhead. Better reimbursement on every claim.
| CDT code | Current | Negotiated | Change |
|---|---|---|---|
| D2740Crown, porcelain/ceramic | $812 | $1,015 | +25.0% |
| D3330Root canal, molar | $780 | $952 | +22.1% |
| D2950Core buildup | $168 | $205 | +22.0% |
| D6010Implant body, endosteal | $1,450 | $1,740 | +20.0% |
| D4341Scaling and root planing, per quadrant | $165 | $198 | +20.0% |
| D2392Composite, two surfaces, posterior | $148 | $172 | +16.2% |
Client details are anonymized. Results reflect actual negotiated fee schedule changes. Every negotiation is different and no outcome is guaranteed.
What makes this different
Carriers receive hundreds of standardized fee increase requests through their portals and rarely act on them. We give each carrier a specific, well-supported reason to move.
We know how carriers evaluate fee increase requests, who makes the decision, and what creates real leverage, because we spent more than two decades inside some of the largest carriers in the country.
Negotiations start through the proper carrier channels and are backed by leadership relationships at Delta Dental, Cigna, Aetna, MetLife, UnitedHealthcare, and others. When a request stalls, we know who can move it.
Before any carrier is contacted, we analyze your reimbursement, claims volume, procedure mix, provider coverage, state Delta Dental dynamics, and direct versus leased network participation. Opportunities are weighted by real volume, not list price.
We handle the analysis, carrier communications, documentation, and follow up. Your team sees how every opportunity is evaluated and why each term is recommended, and you keep final authority over every contract.
How an engagement runs
Most carrier agreements take six to 12 months to secure and implement.
We collect your fee schedules, contracts, network participation, and claims history, then rank every carrier by financial impact and likelihood of movement. You get a negotiation roadmap before any carrier is contacted.
We approach each carrier with a tailored case built from your claims, backed by carrier relationships to escalate where needed. We stay with every negotiation through to a signed agreement.
We confirm the new rates are loaded and paying correctly, and show you exactly what each contract is worth to your practice, line by line.
How we're paid
Choose a performance model, where part of our compensation is tied to the increases we secure, or a fixed fee, where you keep 100% of every increase. The scope of work is the same either way.
Who we work with
Medicaid and government programs are outside our scope.
Our experience
20+ yearson the carrier side of dental and health insuranceWe've spent more than 20 years on the carrier side of dental and health insurance, working for some of the largest carriers in the country. We know how carriers price their networks, how they evaluate fee increase requests, and what it takes to get a yes.
We maintain active relationships across the dental benefits industry and put that knowledge to work for providers, so the people negotiating on your behalf understand both sides of the table.
Questions we hear
No. We negotiate within your existing contracts and through each carrier's proper channels. You approve every proposed term, and nothing changes in your participation without your sign-off.
The initial assessment takes about 30 days once we have complete data. Most carrier agreements take six to 12 months to secure and implement, and multi-state Delta Dental plans and leased network arrangements tend to take the longest.
A completed carrier and network information request, current fee schedules, and 12 months of claims by procedure code, office, and carrier from your practice management system. We provide a simple template and handle the analysis.
Generally, yes. We work as an extension of your team and can operate under your organization's name with written authorization, so carriers deal with a representative of your group. If you would rather have your own staff lead the negotiations, we can be the backbone behind them and guide them through every step.
Calling the 800 number or submitting a portal request with no supporting case is easy for a carrier to decline. We bring your claims profile, market benchmarks, network analysis, and carrier relationships to escalate where needed.
Start with a call
Book a 30 minute call. We'll talk through your locations, carrier mix, and recent negotiation history, and tell you plainly whether there's an opportunity worth pursuing.