Across the dental industry, carriers, practices, and policymakers are facing a new reality. Dental loss ratio requirements are no longer theoretical. They are here. As carriers adjust to these rules, many providers are asking an important question. Does dental loss ratio make it harder to join a PPO network? Is this already happening with carriers ...
New insurance reform laws are shifting control back to dentists and patients. For years, insurance companies set the rules, controlled prices, and limited options. That balance is now starting to change. If you work with PPOs, these updates matter. They affect how much you get paid, how long contracts last, and how much control you ...
We’ve been seeing an uptick in dental credentialing-related outreach lately — both emails and physical mail — coming from various networks and third-party platforms like Skygen and DentalHub. These communications often sound like updates to existing participation or dental credentialing processes, but in many cases, they’re actually new or separate requests. What’s Happening Across the ...
As the Founder of PPO Advisors, I spend a lot of time helping dentists understand the national provider identifier, navigate the maze of insurance, credentialing, and compliance. One of the most common questions I hear is: 👉 “Do I really need a Type 2 NPI for my dental practice?” It’s a great question, because the ...
As of December 1, 2025, Guardian and Principal will enter into a new network sharing arrangement. Guardian providers who participate in the DentalGuard Preferred Select (DGPS) network will automatically become participating providers for Principal’s PPO plan members. This means your office will soon be able to see Principal members under the same Guardian fee schedules ...
In our last blog, we shared the news that Dental Health Alliance (DHA) had entered into a lease share with MetLife. At that time, the agreement was one-way only: MetLife PPO members could access DHA providers in-network, but the reverse wasn’t true. That’s now changed. The arrangement has been updated to be reciprocal, which means ...
Here we go again—another lease share has hit the market. This time, it’s between Dental Health Alliance (DHA) and MetLife. Starting October 18, 2025, MetLife PPO members will gain access to DHA’s network in most states, with a few exceptions rolling out later (CA, IL, VA on Nov 17, 2025; NC, NJ, WA pending approval). ...
Artificial intelligence (AI) is no longer a futuristic concept—it’s already reshaping the way dental insurance companies operate. As the founder of PPO Advisors and someone who spends every day helping dentists navigate the complex world of PPOs, I see both the promise and the pitfalls of this shift. Dentists and practice owners need to understand ...
When buying a dental practice or bringing on an associate, you’ll often hear bad advice: “Just bill under the seller’s NPI until your credentialing is complete.” It may sound harmless, but this practice is considered insurance fraud — and the risks are far greater than the short-term benefit. What is NPI Fraud? – Each dentist ...
In recent weeks, Delta Dental of Wisconsin announced its acquisition of Cherry Tree Dental, a dental practice group with more than 25 locations across Wisconsin and additional offices in neighboring states. On the surface, this move is being positioned as a way to “improve access to care” in underserved communities. But let’s be honest—this is ...