Network Participation Analysis
Put a Number on Staying In, Dropping, or Adding a Network
Dropping, adding, or staying in a network is a financial decision. We do the arithmetic behind it.
The Network Decisions We Analyze
A network decision may stay in place while fee schedules, the mix of procedures, and the patient counts behind each plan continue to change. Practices come to us with a version of the same question:
- We joined a network years ago and don’t know how it affects us today
- A network’s fee schedule changed and no one has recalculated what it now costs us
- We are considering dropping a network but cannot quantify what we would gain or put at risk
- A plan is on offer and we do not know its financial implications or risks
What the Analysis Reviews
Network Fees
The contracted fee schedules your practice is working under, network by network.
Write-Offs
What each agreement writes off against your own fees, rather than against an average.
Procedure Frequencies
Which procedures your practice actually performs, and how often — because a fee schedule only matters in proportion to the work you do under it.
Patient Counts
How many of your patients come to you through each network.
A Simplified Example
Six networks and one piece of arithmetic. If a network writes off a share of your fee, that same share — counted in whole patients, rounded down — is how many of its patients you could lose after leaving it and still collect at least as much.
| Network | Patients | Write-off against your fee | Patients you could lose and still collect at least as much |
|---|---|---|---|
| Network A | 412 | 18% | 74 |
| Network B | 268 | 24% | 64 |
| Network C | 190 | 31% | 58 |
| Network D | 155 | 12% | 18 |
| Network E | 96 | 38% | 36 |
| Network F | 61 | 9% | 5 |
These figures are invented. They illustrate the shape of the calculation and are not benchmarks, averages, or figures drawn from any practice. Network A through F are not real plans. A real analysis uses your own patient counts, your own fee schedule, and the procedures your practice actually performs.
The last column is deliberately narrow. Turning a write-off percentage into a count of patients assumes every patient in a network represents the same average production, and that the work you keep is collected at your full fee — which is what makes it an illustration rather than practice-ready arithmetic. It also holds your fee constant and asks only what happens to collections, so it says nothing about the chair time a departing patient frees, the fixed costs that continue either way, what a change does to referrals and new patient flow, or the mix of procedures behind any one network. A real analysis works through all of that alongside the arithmetic.
What You Get
The Financial Implications
What dropping, adding, or staying in a network would mean, expressed in your practice’s own numbers.
The Risks
What a change would put at risk, presented alongside what it would gain, so neither side of the decision is a guess.
The Arithmetic Behind It
The inputs come from reports and fee schedules you provide, and every calculation stays visible. The analysis is meant to be checked, argued with, and kept.
A Decision That Stays Yours
We do not tell a practice what its network status should be. We do the arithmetic; the decision is the practice’s.
Separate From Insurance Processing
This analysis stands on its own. It is useful to a practice that has no intention of outsourcing anything, and having it done implies no commitment to anything else. If you do want the claims work handled as well, that is a different service and it is quoted separately.
Ask Us
Can Proveer help us decide whether to change our network status?
Yes. We review your network fees, write-offs, procedure frequencies, and patient counts, so that dropping, adding, or staying in a network is a decision made on your own numbers rather than an impression. We present the financial implications and the risks of a change; the decision stays with you.
Do we have to outsource our insurance processing to have this done?
No. The analysis is a separate engagement. If you also want the claims work done, that is our insurance processing service, and the two fit together — but neither requires the other.
What do you need from us to do it?
Access to the reports your practice management software already produces, and your current fee schedules. We work inside your own software rather than copying records into a system of ours, using the information already available there wherever possible.