We are writing to discuss the letter you may have received from your insurance company, Guardian. It has come to our attention that Guardian recently sent letters to patients without our knowledge. This letter was dated April 3, 2025, and states that the office will no longer be participating with Guardian as of May 1, 2025. You can see a sample of this letter below.
What does this letter mean to you?
Absolutely nothing! You can still come to Ocean Smiles and see any of our doctors. Most Guardian plans will still cover your cleanings at 100% by utilizing your out-of-network benefits. Should there be any copays, we will make you aware of those prior to your appointment.
The office never intended to discontinue our in-network participation with Guardian. This was a decision that Guardian made without any knowledge or discussion with my office or my doctors. In light of this letter, Dr. Strouse spoke with several Guardian representatives, including Robert Fischer and Dr. Kevin Poindexter, about this matter. They are trying to strong-arm the office into agreeing to new terms of participation. They want to change the terms from the ORGINAL CONTRACT THAT THEY HAD SET with my office when we decided to participate with them over 15 years ago. They want to be able to control and dictate your treatment and minimize their reimbursements, which is in the best interest of Guardian and NOT our patients.
For now, we will no longer be in-network with Guardian Dental network. We will still accept and participate with Guardian dental insurance as out-of-network providers. This does not mean you need to leave our office and the care you have come to expect. The staff has been researching everyone’s insurance benefits to help provide you with information about your plan. We have noticed that everyone has out-of-network benefits. What does this mean? Well for starters, you can still come to our office and have the same excellent treatment you have come to appreciate. Secondly, it doesn’t necessarily mean you will pay more for your services. Many of the services will still be covered at 100%. Insurance companies sell patients on going to an in-network dentist because insurance companies will save money. In many instances, patients have actually paid less for treatment when seeing an out-of-network doctor. How is that possible you ask? Insurance companies typically pay more for your services which means you pay less for them. Lastly, your insurance company will have less control over your treatment. When you go to an in-network dentist, the insurance company has the right to limit your treatment options to what they believe you need. We have noticed that more services are available to patients when the office is out of network with an insurance company. We want you to stay with us as a valued patient.
We will keep you informed if there are any changes to our provider status. Regardless, we want you to know that you will always have access to our office to provide your dental care. Whether through Guardian, another insurance plan or even our own in-office Dental Loyalty plan, you can always remain as our patient.
We would recommend you reach out to the Guardian representatives for NJ, Robert Fischer or Dr. Kevin Poindexter, and express your issues and dissatisfaction with Guardian’s decision to terminate all of the Ocean Smiles doctors. Their contact information is below:
Robert Fischer, Sr. Regional Manager
Office number: 516-984-6674
Email: [email protected]Dr. Kevin Poindexter, Sr. Network Recruiter
Office number: 804-356-2441
Email: [email protected]
We are always there to help you. Should you have any questions, please feel free to call or text the office at 732-458-9700 and we will do our very best to answer any questions you have. We look forward to hearing from you.
Sincerely,
Dr. Timothy Strouse and the Ocean Smiles team
