When many offices finish the credentialing process with a new insurance provider, they breathe a sigh of relief. After all, they never need to worry about completing the process again, right? Wrong! After the credentialing process has been completed, the recredentialing process immediately appears on the horizon. Depending on your provider, you might need to complete recredentialing every 2-3 years. What are the most common recredentialing mistakes that many dental practices make?


The Recredentialing Process


Recredentialing is a process enacted by insurance providers to ensure that all of their in-network dental providers are meeting the same standards that they were the last time they were credentialed or recredentialed. Just like the initial credentialing process, it can be quite lengthy, require a great deal of paperwork and need tremendous attention to detail to be successful. However, recredentialing can also be a great thing for your dental practice. It gives you an opportunity to renegotiate your reimbursement rates and improve your bottom line. APEX Reimbursement Specialists can assist both with the recredentialing process and your fee negotiation needs.


3 Common Recredentialing Mistakes


  1. Waiting Too Long to Start: Did you know that the recredentialing process timer starts the day that your dental practice becomes an in-network provider for an insurance company? If you get your provider status before your office is open or before you see your first patient, that does not have an effect on when your recredentialing will need to be completed. Make sure that you give yourself plenty of time to complete the recredentialing process, as it requires paperwork and documentation on top of time for the company to process your submission.
  2. Not Following Up: Insurance providers will never contact you proactively to let you know that something is missing or incomplete. Instead, you (or a trusted recredentialing assistant like APEX Reimbursement Specialists) will need to reach out for any updates. We can take care of touching base with all insurance providers to confirm the receipt of the application, review any missing materials and ensure it was accepted.
  3. Not Paying Close Attention: Recredentialing is just as detailed and intensive as the initial credentialing process in some cases, so you must pay attention to detail. Make sure that you have all necessary documents and paperwork gathered before submitting your materials to the insurance provider.


Avoid Recredentialing Mistakes with APEX Reimbursement Specialists


Whether you’re preparing for the recredentialing process or looking for assistance credentialing with a new provider, APEX Reimbursement Specialists is here to help. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.