So, you’ve finished dental school, joined a practice, or bought one, and now you’re sitting there saying to yourself, “What’s next?”
At some point in their career, most dentists have questions about how they should continue to grow professionally. But first thing’s first: Let’s get you credentialed.
No, getting credentialed is not the same as getting licensed. But like being licensed, credentialing is a process you will redo regularly. You must be credentialed with insurance companies to be reimbursed for treating their in-network patients.
If you’re already feeling confused about how credentialing works for dentists, don’t worry: This article will answer 4 credentialing questions asked by every dental professional at some point.
We’ll also zero in on how automating your credentialing and re-credentialing processes can lift a huge weight off your shoulders — and off your dental team’s shoulders, as well.
Let’s dive in…
1. What is dental credentialing?
Dental credentialing is when a dentist enters into an agreement to be in-network with a dental insurance company, accepting the negotiated fees of the contract for access to the insurer’s large network of patients.
Traditionally, the credentialing process usually takes 30 to 180+ days to complete. Various forms of documentation are required during this vetting process to ensure that allowing a dentist to serve patients from their network is in everyone’s best interest. This is the most time-consuming element of becoming credentialed.
So why is this vetted information so important?
Well, although there are perks to becoming an in-network provider for an insurance company, there are also specific guidelines within the contract that you need to be comfortable with prior to signing. Things such as audits, services that can not be billed to the patient regardless of necessity, and bundling of services to reimburse at a lower rate may not be ideal for you in the long run.
You may be asking yourself, “If the insurance company is going to dictate the dentistry I can provide and what I can bill my patients, then why would I go in-network with them?”
We’re glad you asked!
2. Why should I credential with a dental insurance network?
By contracting with an insurance company, you will receive direct access to a large pool of new patients.
Being in-network serves as free marketing to a captive audience. Your practice will be listed on the insurance company’s website as a preferred provider — as patients search for providers in their area, you’ll show up.
When a patient is given the option to:
See an in-network provider and pay zero out-of-pocket expenses for a cleaning or
Go to an out-of-network provider and run the risk of paying any amount out of pocket…
Most patients are going to choose to see the in-network provider. The majority of patients who pay for dental insurance don’t want any extra expenses for dental care they deem to be ‘free’ — basically, the majority of preventative services.
Also, a patient’s willingness to accept proposed dental work increases with a dentist who is in-network. The reduced fees you agree to accept — per your contract with the insurance company — are more appealing to patients when they know their insurance has discounted the fee and will pay a portion.
We’re sure you hear it every day when discussing treatment: “What will my insurance cover? How much will I have to pay?”
3. How does automated credentialing work?
As you can gather and may have experienced, the traditional credentialing process is notoriously cumbersome. And credentialing delays are costly — your ability to generate revenue is on hold until final approval comes through. As mentioned earlier, that will take 30 days to 6 months, or even longer.
Monitoring the status for months is one of many reasons why you should automate your credentialing process. Remove the administrative headache that comes with the traditional credentialing process, and let our experts handle it for you to receive quicker status approval.
Here’s how DCS Credentialing works, to give you a better idea of what to expect…
Our automated credentialing services ensure cost-efficient, secure enrollment administration that goes from call center; to data collection, data entry, and data integrity; to integration and analytics — whether you’re in private practice, formed a group of offices, or run a DSO with dozens of dentists.
Through our credentialing services, you’ll also have access to an up-to-the-moment view of your credentialing status on a clean, easy-to-use dashboard that’s available 24/7. Traditional credentialing, on the other hand, leaves you in the dark for a month or more.
If you’re concerned about compliance, be assured that DCS’ technology-based dental credentialing services are performed by a certified Credentials Verification Organization (CVO) that ensures the highest degree of National Committee for Quality Assurance (NCQA) standards.
4. How will I know when I’m completely credentialed — or re-credentialed?
When you use our automated credentialing services, we handle the entire process for you, and you will see in your personal dashboard when your status updates.
And when you sign up for a subscription, our experts will also work proactively to re-credential you before the deadline, so you will never have to remember to reapply or wait on approval before continuing with reimbursable treatments.
Will Snipes, our Assistant VP of Strategy and Special Projects, details this innovative feature:
“In our system, there is a transparent view as to when the re-credentialing dates roll around for the provider to see themselves, that our team also monitors. We seamlessly and proactively begin the re-credentialing process on their behalf and make sure that all documents are current.
The idea behind it is that we work to initiate that process with the provider office before they notify us they need to be re-credentialed.”
Imagine never again having to worry about the day you’ll need to send in all the paperwork to be re-credentialed. It will no longer be a looming task in the back of your mind; a critical task that you and your team will have to stop everything to make time for.
Let us take care of your re-credentialing. We’ll handle all the details year after year — and you’ll always be in the loop, instead of in the dark.
Automate your credentialing process with DCS’s time-saving credentialing services
To recap, we answered 4 big questions about credentialing and how automated credentialing services work:
What is dental credentialing?
Why should I credential with a dental insurance network?
How does automated credentialing work?
How will I know when I’m completely credentialed — or re-credentialed?
Now that you know more about the importance of credentialing, the problems with traditional credentialing, and how our automated credentialing greatly improves on the old way, you can take the next step to learn what DCS Credentialing can do especially for your dental business.
Our experts will take credential-related tasks completely off your plate and your team’s, monitor your application’s status to ensure you are always credentialed, and take steps to re-credential you when necessary.
You’re just one phone call away from providing treatment without worry or headaches, and collecting the revenue that’s needed for your business to thrive without interruption.