The process of credentialing verifies dentists and those who assist them are properly trained and certified and have the experience to provide dental services to patients. It also ensures high standards of safety are met. If a dental office does not have the proper medical credentialing, it typically cannot obtain reimbursements from insurance services including Medicaid/Medicare. All types of medical software are designed to be utilized by offices that are medically credentialed. There is no way to thrive in the dental industry without proper credentialing.
It is of the utmost importance that all dental professionals have an understanding of medical credentialing. It is paramount to make sure all medical professionals are proven qualified to treat patients. The process of keeping up with credentialing is difficult and time-consuming; however, it is necessary so everyone in your dental practice remains in-network to decrease the chance for loss of income.
Credentialing does require a mountain of paperwork, which includes proof of the following:
- work history
- licenses if required
- specialty certificates
- malpractice history.
The process must be repeated every 2-3 years to remain in the insurance network.
Let’s take a look at some reasons your dental practice should outsource the credentialing process. Save your dental staff the headaches, as well as make the process go smoothly and end positively for everyone.
Avoid Missed Deadlines
Did you know you can fail to re-credential just by missing the deadline date? This can cause the serious problem of falling out of network and will cost your practice in the long run. If you outsource, this issue can be avoided. The party you choose to complete these actions for you will track the schedules, send reminders, and make sure all required paperwork is submitted correctly and on time. Problem solved!
Reduce Staff Stress
It requires so much time to credential, and it puts a ton of stress on your administrative team. Not only are they required to keep up their regular routine, but they also have the added burden of all the other paperwork. If you choose to outsource the work, you can rest in knowing you have an experienced and knowledgeable team that knows the process well. As a result, the credentialing and re-credentialing will be done correctly and will leave your dental team free to focus on your patients.
Improve Accuracy and Efficiency
Whomever you choose to outsource your credentialing services will have the most up-to-date software to assist them with the process. This will reduce the chance of manual errors in spreadsheets, paper documents, and checklists spread everywhere. Cloud-based systems make it much easier to verify, update, and check for errors.
Get a Better Fee Schedule
If you decide to re-credential, you may just quickly begin the process without thinking about reviewing the terms of your current contract with the insurance provider and missing out on the opportunity to negotiate something better. If you outsource, you will have the benefit of an experienced representative to look over your previous contract and advise you whether to renew, renegotiate, or look for other options.
Get the Support You Need
If you outsource, you also have the opportunity to choose how much support you want or need by utilizing your chosen credentialing source to access tools to assist you with tracking information you require, such as licenses, fee schedules, and deadline reminders. You will also have personal support from someone who is experienced and can answer any questions you may encounter.
Having fully credentialed dentists and staff makes your patients more confident about their dental care. It also makes your dental practice more attractive to other employees such as dentists, hygienists, dental assistants, and support staff. Your professionalism will be irrefutable with access to all your documentation, as well as an assurance to all your current and new patients. Credentialing is proof to private health insurance companies, so your staff can work with patients. It helps to decrease medical errors.
Any new team member candidates should begin the process of credentialing as soon as possible, as it could take up to four months to complete the process. Human resource staff may want to create and prepare credentialing packets to help them. It is important to try to identify any delays that could be encountered during credentialing new hires, so your dental practice does not skip a beat in patient care and revenue continues to flow.
PPO Negotiation Solutions is a trusted partner to many dental practices just like yours. We have built an impeccable reputation after 30 years of experience. Our unique process helps to save your dental practice time and increases your new patient prospects. PPO Negotiation Solutions helps you operate your dental office with PPOs from a position of power! Contact us today!