How Dental Credentialing Can Supercharge Your Success

Many dentists enjoy high levels of job satisfaction. After all, this career path offers ample opportunities to help patients, build lasting relationships, and strike a healthy work-life balance.

Dentistry can also be quite profitable, particularly if you manage your dental credentialing with care. This essential process is one of the most effective methods for expanding your patient base and enhancing your revenue.

So, what is dental credentialing? And how long does it take? Below, we’ll explore the importance of dental credentialing, outline the steps involved, and offer ways to expedite the process.

What is Dental Credentialing?🔗

Dental credentialing is the process of becoming an in-network provider for an insurance company. Once you submit your application, insurance companies will make sure that you’re in good standing with regulatory bodies and satisfy all relevant legal and professional standards.

Once credentialed, you must adhere to your insurance payers’ contractual agreements. For example, you may need to follow certain fee schedules or patient copayment guidelines. While dental credentialing can be complex and time-consuming, it’s well worth the investment. As an in-network provider, you’ll enjoy the following benefits:

• Access to a broader patient base – Most patients prefer to work with dentists in their insurance network to avoid paying out-of-pocket costs. Thus, becoming an in-network provider can instantly expand your patient base.
• Increased revenue – Dental credentialing is one of the easiest and most effective ways to market your practice. As patients find you through their insurance networks, you can increase your revenue and collect reimbursements for your services.
• Reduced administrative burdens – By enrolling your practice in established insurance networks, credentialing can simplify your dental billing and insurance claims process. With fewer administrative tasks on your plate, you can focus more on providing high-quality patient care.

Read More: 3 Reasons Why Dental Claims Are Rejected

4 Steps in the Dental Credentialing Process🔗

Since dental credentialing offers such powerful perks, you may be curious about what the process entails. Here are the steps involved in becoming an in-network dental provider.

#1 Gather Your Documents🔗

This step ensures a seamless dental credentialing process. Some of the key documents you’ll need include your:

• Proof of education and board certifications – To start, make copies of your school diplomas, certifications, and proof of any advanced training.
• Curriculum vitae (CV) – Next, create a detailed resume outlining your education, work experience, and professional achievements. Unlike a typical one-page resume, CVs should be all-inclusive and can be several pages long.
• Dental license and malpractice insurance – Dental networks want to see that you have up-to-date licenses and insurance.
• References and compliance records – Insurance companies will carefully vet your professional references and compliance history to determine your reputation in the industry.

Remember that every insurance company has different requirements, so some applications may ask for more detailed information than others.

#2 Complete and Submit Your Application🔗

Once you’ve gathered your documents, it’s time to submit your application to the various insurance networks you want to join. If you’re unsure which providers to choose, consider asking other dentists in your area. Ideally, you should select networks that are easily accessible to patients in your community.

Once you submit these applications, insurance companies will verify the authenticity of your documents through direct sources, such as your educational institutions and the state licensing board. Note: Group credentialing isn’t permitted, so every dentist in your practice will need to submit a separate application.

#3 Undergo Background and Compliance Checks🔗

Insurance companies will carefully review your employment history and professional references while verifying your documents. They want to make sure that you don’t have any criminal convictions, malpractice claims, or disciplinary actions that could pose a risk to their beneficiaries.

During this phase, some insurance companies may ask you to provide additional information or clarification, so keep a close eye on your application status to avoid unnecessary delays.

#4 Finalize the Payer Enrollment Process🔗

Once insurance companies have vetted your professional standing and approved your eligibility, they’ll officially enroll you in their network. At this point, you can negotiate your fee schedule before accepting your final agreement.

How Long Does Dental Credentialing Take?🔗

Dental credentialing can take anywhere from 90 to 120 days. The speed of your credentialing process ultimately depends on:

• The complexity of the application
• The completeness of your documents
• Your chosen insurance companies

Since this process can take several months, it’s important to start it as soon as possible.

Common Challenges and Delays🔗

The most common reasons for dental credentialing delays include:

• Inconsistent requirements – Every insurance payer has slightly different documentation requirements. If you don’t tailor your applications accordingly, you may forget to include certain documents in more detailed applications.
• Application errors – Insurance companies are meticulous during their screening process, so even small mistakes can delay your dental credentialing.
• Neglecting follow-up – If you don’t track your application’s status, you may forget key deadlines or miss requests for necessary follow-up information.

Every day without active dental credentialing is a missed opportunity for new patients and potential revenue, so it’s crucial to avoid these delays and expedite the process as much as possible.

How to Expedite the Dental Credentialing Process🔗

To ensure an efficient dental credentialing process, just follow these steps:

1. Prepare proactively – You should start gathering your application documents as soon as possible–ideally, the day that you hire a new dentist at your practice. When you submit your application, make sure these documents are accurate and current.
2. Streamline submission and tracking with software – Rather than dealing with cumbersome paperwork, submit your documents via credentialing software instead. This automated approach can improve your applications’ accuracy and speed up processing times.
3. Adhere to an attentive follow-up process – Once you submit your application, track its progress through each review stage. You should also consider setting up automatic reminders for credentialing and license renewals so you never fall out of compliance.

Helpful Dental Credentialing Resources🔗

As you navigate the dental credentialing process, it helps to have time-saving tools at your disposal. Some valuable resources include:

• Detailed guides and checklists – These tools can help you stay organized and keep track of your progress throughout the application process.
• Credentialing software – If you prefer to handle the dental credentialing process in-house, centralized software can streamline your document management and application status tracking for every dentist at your practice.
• Outsourced support – If managing the dental credentialing process sounds overwhelming, you can always outsource it to an expert, like Medusind. Our dental insurance eligibility verification service can reduce your administrative workload and ensure accurate application submissions.

Read More: A Guide to Submitting Accurate Dental Billing Claims on Time

Reap the Rewards of Dental Credentialing with Medusind🔗

Most dental office administration staff don’t have the time, training, or expertise to assemble accurate credentialing applications on their own. That’s where Medusind’s credentialing experts can make all the difference.

Our dedicated team provides comprehensive dental credentialing services, enabling you to secure timely approvals and maintain flawless compliance, all while remaining focused on patient care. During our comprehensive credentialing process, we’ll collect your:

• Dental school information
• Board certifications
• CV
• Dental license
• Malpractice insurance
• Internship and fellowship documents

After that, we’ll take care of the rest of the steps on your behalf, from submitting your applications to monitoring your re-credentialing schedules.

Want to learn more about Medusind’s systematic approach to dental credentialing? Contact our team today!