By Shelley DeGroff, Founder of PPO Advisors If you’ve ever had money pulled from your claim payments because of an overpayment made to a completely unrelated provider—buckle up. You’re going to like this. MetLife just announced they’re changing how they handle overpayment recoupments. Thanks to pressure from the ADA, they’ve agreed to stop taking money ...
By Shelley DeGroff, Founder of PPO Advisors A big change is coming this fall that could impact your PPO reimbursements, and I want to make sure you’re ready. Starting September 1st, 2025, Aetna and MetLife will roll out a two-way share agreement that affects how you’re connected to patients across both networks. As the Founder ...
By Shelley DeGroff, CEO of PPO Advisors As the CEO of PPO Advisors, I’ve witnessed firsthand how outdated PPO contracts can silently erode a practice’s profitability. Many providers are unaware that simply updating their CAQH profile can inadvertently recredential them into old contracts, leading to decreased fee schedules and unintended contractual obligations. The Hidden Dangers ...