The Guardian Dental Network Shake-Up: What Providers Need to Know
By Shelley DeGroff, CEO of PPO Advisors
Lately, there’s been a lot of noise surrounding Guardian and its relationships with shared networks and third-party lease arrangements—particularly with Careington and Connection. As a company deeply entrenched in navigating the PPO landscape, we’ve been watching this situation closely.
Unfortunately, like many of you, we’re being forced to piece things together due to a lack of transparency. Guardian is holding their cards close to the chest, leaving providers and support partners like us scrambling to make sense of the fallout.
What We Know So Far
Here’s what we can say with confidence:
👉 Guardian is notifying patients directly—not providers—that their current Guardian in-network dentist will soon be out-of-network.
👉 These notifications are targeting providers who are affiliated with Guardian through a lease agreement, rather than a direct contract.
👉 Alarmingly, most providers are unaware they are being dropped because Guardian doesn’t consider it their obligation to inform non-direct partners. It’s up to the lease network (like Careington or Connection) to issue that notice.
👉 We’ve spoken with the lease partners, and they too were blindsided. They acknowledged they’re still working on a strategy and plan to release communication soon.
👉 A common denominator? Providers with higher-than-average fee schedules for their area are the ones being affected the most. This leads us to believe these terminations may be a cost-control effort by Guardian.
Why This Matters
For years, we’ve known that participating with a network via a lease doesn’t offer the same protections as a direct agreement. Still, once accepted through a lease, it’s highly unusual for a provider to be removed without notice or cause. This current disruption is not only disappointing but feels like a betrayal of good faith—especially given the significant impact it has on both providers and their patients.
Guardian’s actions are not just administrative; they affect real people. Patients are left confused, wondering why their trusted provider is no longer covered. Providers are blindsided, left with no time to prepare or communicate proactively. And support teams like ours are left navigating damage control in real-time.
Our Action Plan
At PPO Advisors, we are committed to being proactive, not reactive:
👉 If you are a current client, your project manager will be reaching out to discuss what this change means for your practice and help implement a backup strategy to minimize disruption.
👉 If you are not currently a client, we strongly encourage you to take action by reaching out directly to Guardian and your lease partners. Ask for clear answers and demand transparency around your network status. You can also escalate your concerns by contacting your state’s insurance commissioner—letting regulators know how these sudden and unclear changes are affecting your practice and your patients.
If you’d like expert help navigating this situation and building a long-term PPO strategy, we invite you to connect with PPO Advisors. We’re here to support you through the chaos and share how our services can bring clarity and control to your PPO participation.
Final Thoughts
This situation is exactly why PPO navigation is so challenging—and why it’s more important than ever to have someone in your corner. We’ll continue to advocate for transparency and fairness on your behalf, and we’ll keep you informed every step of the way.
Stay tuned, stay informed, and don’t hesitate to Contact Us with your questions.