Dental Credentialing Services
Are you losing dental patients because you don’t accept their insurance? Expand your network, increase patient access, and ensure no treatment is left behind.
Get Credentialed, See More Patients, and Grow Your Revenue!
What is Dental Credentialing?
Your growth is our growth; it’s as simple as that. Get a free billing consultation now to discuss how we can improve your billing process, ensuring 100% payment collection from both payers and patients with first-submission approval.
We offer a one-month complimentary billing audit for practices, allowing them to experience our services firsthand and assess whether we deliver on the promises outlined in our claims.
Joining a PPO Network & Its Benefits
Preferred Provider Organization (PPO) network have multiple benefits, if you’re a dental provider agreeing to the serving patient at a discounted rate in exchange for being listed as an in-network provider you will get increased patient flow since many patients prefer using in-network providers as they get lower out-of-pocket expenses. The other benefits include more predictable reimbursement rates, and long-term patient relationships.
However, joining a PPO network also requires dentists to adhere to the network’s fee schedule and contractual obligations. Credentialing ensures the dentist meets the network’s standards for qualifications and practice protocols. Ultimately, PPO participation can lead to higher practice visibility and financial stability.
Our Dental Provider Credentialing Process
Our credentialers have made the process smooth and easy to follow for the providers, ensuring they understand where their data is being used, how it is being used, and at which stage of the credentialing process their application is. The process we follow is:Your growth is our growth; it’s as simple as that. Get a free billing consultation now to discuss how we can improve your billing process, ensuring 100% payment collection from both payers and patients with first-submission approval.
We offer a one-month complimentary billing audit for practices, allowing them to experience our services firsthand and assess whether we deliver on the promises outlined in our claims.
Data Gathering
The first step is to gather all the information from the provider that is required by the payer they are applying to be credentialed with. However, we typically collect the data and information needed by the maximum number of insurers in the state. This ensures that the provider will be able to apply to different payers, both now and in the future, as needed.
Verifying The Information
Before providing the provider’s information to the insurance, we verify it through legal resources to ensure we are not missing any documentation that could delay the process or lead to appeal rejections. This step includes verifying the dental license, specialty certification, DEA registration, and more.
Providing the Payers with Credentials
In this step, we provide all the required documentation from the provider to the insurance company for enrollment. It is crucial that all the documentation is correct, accurate, verified, and up-to-date.
Contract Negotiation
The last step of credentialing, before approval, is for the provider to adhere to the contract, which includes various policies and rules regarding patient care and credentialing, in order to be enrolled with the payer. After completing all these steps, the provider can begin treating patients, and we ensure that these same steps are followed, making the process hassle-free for the provider.
Compliance
HIPAA compliance is essential for everyone in the healthcare industry. Additionally, providers must meet various other compliances to treat patients or enroll with an insurance company. Including:
- Accreditation by ADA (American Dental Association): Voluntary process in which dental practices are evaluated for quality assurance against ADA standards.
- NPI Registration (National Provider Identifier): A unique identification number for healthcare providers required for billing and administrative purposes.
- DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies): Refers to medical equipment and supplies that are prescribed for long-term use and covered by Medicare.
- PQRS (Physician Quality Reporting System): A system for reporting quality measures in dental practice to Medicare to receive incentives or avoid penalties.
- State Licensing: The process through which a healthcare provider or facility is officially authorized to operate in a specific state.
- CLIA Registration (Clinical Laboratory Improvement Amendments): Certification required for laboratories to ensure they meet federal quality standards for testing.
- DEA Certification (Drug Enforcement Administration Certification): A license issued to healthcare providers to prescribe controlled substances legally.
Credentialing With Medicotechllc
Dental Credentialing Experts
AAPC-certified credentialing experts can help you get credentialed in a timely manner, so you can start treating patients as soon as possible.
Faster Credentialing
Faster means more revenue coming in. Medicotech LLC helps providers follow the process on their own, making the verification and compilation of documents quicker.
Flexible Customer Support
Good services require continuous support. To address our clients’ queries and issues, we are available 24/7.
Transparency & Clarity in Follow-Ups
The most common issue faced in credentialing are delays in approvals or feedback, but our experts proactively follow up and ensure transparency.
CAQH Profile Management
Managing credentialing information and compiling documents repeatedly when applying to different providers can be both time-consuming and frustrating. This is where the CAQH (Council for Affordable Quality Healthcare) proves to be extremely helpful. As a non-profit organization, CAQH offers a centralized digital platform for healthcare providers to submit and manage their credentialing information. With our assistance, you can easily maintain and update your CAQH profile.
Dental specialists benefit from this the most, as they work with multiple patients covered by various insurance providers.
Big Practice Or Small Practice
No matter the size of your specialty or the number of patients, we provide quick credentialing for facilities of all sizes. With Medicotechllc, you'll be credentialed quickly, with precision, and receive first-time approval.
Stop Losing Patients & Revenue! Get Credentialed Now.
Recredentialing
On average, dental specialists require recredentialing every 3 years. This process can be time-consuming and challenging if there are discrepancies or incomplete information. While it occurs every 3 years, it's important to be prepared for it, as delays can result in lost revenue and cause your practice to fall behind.
FAQ’s
What is dental credentialing, and why is it important?
Dental credentialing is the process of verifying a dentist’s qualifications, including education, licensure, training, and professional background, ensuring they meet required standards. It is crucial for patient safety, legal compliance, and ensuring competent care. Credentialing also allows dentists to join insurance networks and receive reimbursements.
How long does the credentialing process take?
The dental credentialing process usually takes between 30 to 60 days, though it can extend up to 90 days depending on factors such as the completeness of the application, verification of educational and professional history, and responsiveness from licensing boards or insurance companies.
Can a credentialing company help me get on more insurance networks?
Yes, a credentialing company can help you get onto more insurance networks by handling the application, verification, and submission process efficiently. This increases your chances of being approved for multiple networks. At Medciotechllc, we specialize in streamlining this process to expand your practice’s reach and improve reimbursement opportunities.
What documents are required for the credentialing process?
The dental credentialing process typically requires proof of identity (passport or driver’s license), dental school diploma, state dental license, DEA certificate, malpractice insurance details, Curriculum Vitae (CV), continuing education certificates, and a National Provider Identifier (NPI) number. Additional documents may include Social Security or Tax ID number, W-9 form, Medicare/Medicaid enrollment, background check consent, and references.
How often do I need to be recredentialed, and how does the process work?
Dental recredentialing typically occurs every 2 to 3 years. The process involves verifying your credentials again, including license, malpractice insurance, and continuing education, to ensure you still meet the standards for participation in insurance networks. The insurance company will request updated documents and may require a background check before reapproval.
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