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 ...
Major PPO Changes Ahead: What You Need to Know About New Shared Agreements The PPO landscape is shifting quickly, with new shared agreements between major carriers set to roll out over the next few months. These agreements can directly affect reimbursements, participation, and patient flow in ways many practices don’t anticipate. At PPO Advisors, our ...
What You Need to Know: The New Cigna–Ameritas Shared Agreement Starting November 1, 2025, Ameritas members will gain in-network access to participating providers in the Cigna PPO Shared Administration Network. This new shared agreement between Cigna and Ameritas is something every dental practice needs to understand, because it may have a direct impact on your ...
Exciting Update: Cigna Leases Its Dental PPO Network to Humana—Effective November 1, 2025 Attention Dental Providers: Big news is unfolding this fall from Cigna! Beginning November 1, 2025, Cigna has entered into a third-party leasing agreement with Humana Dental PPO, extending to Humana Dental, FEDVIP PPO, and TeamCare members. How This Arrangement Affects Your Practice ...
Why Your UCRs Matter More Than You Think in PPO Negotiations As the founder of PPO Advisors, I’ve worked with countless dental practices across the country. One of the most common — and costly — mistakes I see is practices setting their Usual, Customary, and Reasonable (UCR) fees too low. What many providers don’t realize ...
If your dental practice treats Medicare Advantage patients, 2026 will bring some of the biggest changes we’ve seen in years—especially with Aetna. While insurers have been quietly tightening networks and trimming benefits, Aetna’s most recent move will directly affect how dental providers can participate in its Medicare Advantage network. Aetna’s Changes in a Nutshell Nearly ...
Q1: At a high level, what does PPO Advisors do, and how did you get started? A: Absolutely. I’m Shelley DeGroff, founder and CEO of PPO Advisors, formerly known as IDS PPO. We’ve been in business since 2013, now operating under the name PPO Advisors (ppoadvisors.com). Our mission is clear: we provide ppo solutions and ...
By Shelley DeGroff, Founder of PPO Advisors Why This Blog Matters There are many credentialing platforms that dental networks utilize—CAQH, DentalXChange, and now most recently, Skygen. The challenge? There’s no unified system, and each network chooses its own path. That leaves practices constantly guessing which portal to use, and when. This blog isn’t about endorsing ...