Why Terminating Old PPO Contracts Is Critical for Your Practice’s Financial Health

By Shelley DeGroff, CEO of PPO Advisors As the CEO of PPO Advisors, I’ve witnessed firsthand how outdated PPO contracts can silently erode a practice’s profitability.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 ...

Filed Under: PPO Advisors

Update on the Guardian Dental Lease Affiliation Term Issues: Direct from Guardian

By Shelley DeGroff, CEO of PPO Advisors Following the overwhelming response to our recent blog addressing the confusion around Guardian Dental’s lease affiliations with Careington and Connection, we were contacted directly by Guardian for a conversation. We appreciate their willingness to engage with us and begin clarifying the facts of this complex situation. Here are ...

Filed Under: PPO Advisors

The Guardian Dental Network Shake-Up: What Providers Need to Know

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 ...

Filed Under: PPO Advisors

Big News: United Healthcare & United Concordia Elite Plus — What It Means for Your Practice

Big News: United Healthcare & United Concordia Elite Plus — What It Means for Your Practice By Shelley, CEO & Founder of PPO Advisors If you’ve been paying attention to the latest insurance developments, you may have heard the announcement about United Healthcare’s new relationship with United Concordia Elite Plus, set to take effect in ...

Filed Under: PPO Advisors

Fee Schedules Too Good to Be True? What Every Dental Practice Needs to Know

Fee Schedules Too Good to Be True? What Every Dental Practice Needs to Know By Shelley DeGroff, Founder & CEO of PPO Advisors At PPO Advisors, we work with dental practices across the country who are striving to get the best possible reimbursement rates — and for good reason. Negotiating competitive fees is vital for ...

Filed Under: PPO Advisors

Taking the Leap: Embracing Out-of-Network Patients in Your Dental Practice

Taking the Leap: Embracing Out-of-Network Patients in Your Dental Practice Let’s face it: the phrase “Out-of-Network (OON)” can send shivers down even the most seasoned dentist’s spine. If you own a dental practice, the thought of stepping into the OON world might feel like diving into uncharted waters. But here’s the good news: you don’t ...

Filed Under: PPO Advisors

New Changes Coming in March 2025: Sun Life DHA and Cigna Join Forces! Here’s What You Need to Know.

Attention Dentists and Office Managers! We’ve got some important news that could impact your practice starting in March 2025. Sun Life’s Dental Health Alliance (DHA) and Cigna are teaming up to combine their networks. This means that Sun Life DHA and Cigna PPO providers now have shared access to each other’s networks. Sounds like big ...

Filed Under: PPO Advisors

Why PPO Advisors Is Worth the Investment

Why PPO Advisors Is Worth the Investment: A Commitment to Excellence, Results, and Transparency When it comes to PPO (Preferred Provider Organization) consulting, choosing the right firm can be a game-changer for your practice. Many firms promise quick fixes and cost-effective solutions, but what’s the real cost when you settle for the cheapest option? At ...

Filed Under: PPO Advisors

Important Changes for GEHA Patients Starting January 2025

As of January 1, 2025, GEHA and Cigna will no longer allow the communication of Cigna’s fee schedules. This change could significantly impact how you serve your GEHA patients, especially if you’re not part of other lease agreements that facilitate communication with GEHA plans. Why does this matter? If your practice relies on Cigna’s fee ...

Filed Under: PPO Advisors

Navigating Insurance Credentialing During a Practice Transition: A Guide for Dentists

Transitioning into ownership of a dental practice is an exciting yet challenging journey, especially when it comes to navigating the complexities of insurance credentialing. If you’re acquiring a practice that is contracted with multiple Preferred Provider Organizations (PPOs), understanding the credentialing process is essential for a seamless transition. One common question dentists often ask is, ...

Filed Under: PPO Advisors