A Recredentialing Refresher

Every dental practice must go through the recredentialing process for every insurance provider every 2-3 years, depending on the provider. While that might sound straightforward, credentialing and recredentialing are anything but simple! Every year, APEX Reimbursement Specialists works with dentists operating under a number of misconceptions about what the process is, when it must be completed and how to complete it. Here’s a quick refresher to get your practice back on the right track.

What Recredentialing Is

  • A process to make sure that your dental practice’s information is the same as the last time that credentialing took place
  • A process that must be completed with every insurance network you are a part of
  • A potentially-lengthy experience requiring a great deal of follow-up to ensure that the application was received, processed and accepted

What Recredentialing Isn’t

  • A one-time process that will not need to be completed again
  • Mailing back an application and assuming it was received and approved

The Top Recredentialing Misconceptions and Mistakes

  • Timing: Recredentialing begins the day that you join an insurance network, not the date that you move to a new office. If you are not sure when you need to credential or recredential (or what your current status is), you should work with a credentialing specialist like APEX to ensure your practice is in compliance. The date of your contract does not necessarily coincide with the date of your credentialing.
  • Not Following Up: Many dental practices fill out the paperwork to complete the process, mail it back to the insurance company and assume that it was processed. This is a huge mistake. One of the primary reasons why many dentists choose to use a credentialing service is so that follow-up can take place along every step of the way and the application will not be lost or denied without notification. If you don’t follow up and your application was not processed and approved, you will be subject to the newest version of the provider agreement and the newest reimbursement rates.
  • Skipping Steps: The recredentialing process requires the same amount of care and follow-up as the initial credentialing process. You need to have all of your documentation and paperwork together to submit at the same time. Insurance companies are often overwhelmed and will not take time to follow up on an individual basis to ask for additional paperwork.

Keep Your Practice Up-to-Date with Help from APEX

Whether you’re due for recredentialing or struggling to meet your practice’s goals, our experts can 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.