Before you assume this doesn't apply to your practice, think again.

Guardian’s latest move may have already affected your network status—and you might not even know it. What’s worse? Your patients might find out before you do. Read to the end to find out how to protect your revenue, your reputation, and your relationships.

In a quiet but significant move, Guardian Life has begun removing dental providers from its network—without directly notifying them. If you’re contracted through leased PPOs like Connection Dental or Careington, your practice may already be affected. And if not, it could be next.

This is more than a contract update. It’s a strategic play by Guardian to cut costs by eliminating access to higher-paying fee schedules—often without the courtesy of warning the providers impacted. Instead, patients are receiving letters stating their dentist is “no longer in-network,” leaving practices scrambling to explain changes they weren’t even aware of.

Why This Is Happening

Guardian is targeting providers operating through leased network arrangements, especially those with reimbursement rates above the insurer’s desired thresholds. These aren’t random removals—they’re data-driven eliminations focused on cost containment.

In many cases, even the third-party lease networks were unaware of the changes until patients started calling. This lack of transparency is more than inconvenient—it’s a serious threat to your bottom line and your reputation.

This Isn’t an Isolated Incident—It’s a Pattern

What’s unfolding with Guardian is part of a broader shift in PPO behavior. Insurance companies are tightening their grip on fee schedules and reducing their exposure to leased network payouts. It’s no longer enough to know if you’re in-network—you need to know how you’re in-network.

If your practice is connected to PPOs through third-party leases, your position is more fragile than you think. These “quiet terminations” are just the beginning.

Behind Closed Doors: What Guardian Really Said

When confronted about the abrupt terminations and the pressure being placed on providers to accept significantly lower-paying direct contracts, Guardian executives didn’t deny it. In fact, they were unapologetic—openly acknowledging that these moves were about increasing profit margins, not improving patient care or provider relations.

Rather than address the disruption this is causing for patients and practices alike, they brushed off the concerns with a dismissive attitude. The message was clear: this wasn’t an oversight. It was a calculated financial decision—and one they fully intend to stand by.

What You Should Be Doing Right Now

1. Audit Every PPO Relationship
Identify whether you’re connected directly to each payer or through a leasing network. Many providers don’t even know the answer—and that’s where the danger lies.

2. Demand Clarity in Writing
Call each payer and third-party network and request written confirmation of your current participation status. If they won’t put it in writing, assume you're at risk.

3. Get Ahead of the Patient Narrative
Never let your patients find out through a carrier letter that you're “out-of-network.” Communicate early, clearly, and confidently. You can retain most of those patients—but only if you control the message.

4. Strengthen or Exit Vulnerable Contracts
You don’t have to accept being underpaid or mistreated. Evaluate whether you’re better off renegotiating, converting to direct contracts, or walking away entirely.

5. Train Your Team to Handle the Fallout
Equip your front desk with scripts, talking points, and confidence. Confusion leads to cancellations. Clarity leads to loyalty.

6. Report Abuses When Necessary
If you’ve been removed without formal notice or believe the carrier’s actions are noncompliant, don’t stay silent. File a formal complaint with your state’s Department of Insurance. These watchdogs can’t act unless you speak up.

The Big Picture

You cannot afford to be passive in 2025. Insurance carriers are restructuring networks, cutting costs, and shifting risk—all without regard for how it impacts your patients or your practice.

The practices that will survive—and thrive—are the ones that know how to take back control. That means scrutinizing every contract, refusing to rely on leased network shortcuts, and making informed, empowered decisions about how you interact with PPOs.

The game has changed again. But you’re not powerless—unless you choose to be.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com