Common Credentialing Application Mistakes

Whether you’re a new dental graduate going through the credentialing process for the first time or a seasoned dentist starting the credentialing process with a new insurance provider, it’s easy to get overwhelmed. Many dentists make simple mistakes on credentialing applications that cause the process to be unnecessarily lengthy or come to a standstill entirely. What are the most common credentialing application mistakes and how can you avoid them?

Not Asking for Help

The credentialing process is labor-intensive, from entering data to proofreading the final application. Relying on your own staff members can mean bogging everyone down with a great deal of stress and delays throughout the process. If you choose to partner with credentialing experts, like those at APEX Reimbursement Specialists, the entire process will be handled by experienced professionals who work with dental practices and insurance providers every day.

Not Challenging Delays in the Process

Insurance providers are overwhelmed with applications, and a great deal of foot-dragging can occur when the provider doesn’t feel pressure to process the application promptly. Challenge the delays along the way. Make sure that providers have received the applications, ask for regular status updates and don’t be afraid to provide them with copies of your UPS or FedEx receipts. When it comes to dealing with insurance providers, the squeaky wheel gets the grease.

Thinking You’re Doing It Just Once

The credentialing process is not a one-time thing, as recredentialing must be completed regularly. If you complete the entire process without taking notes or creating systems to make things more efficient next time, you will end up expending the same tremendous amount of effort all over again. Creating a sustainable process that can be undertaken more than once is essential to repeated success.

Sending in an Incomplete Application

Another common mistake is sending a credentialing application that is missing portions or incorrect. Application issues lead to long delays and can lead to outright denials. In many cases, providers will not reach out to you to get the right information, so skipping follow-up on an incorrect application could mean being stuck in limbo for months or years.

Starting Too Late

When you complete the credentialing process, you are not on your own timeline. Instead, you are on the timeline of the payer. You should allow your practice at least 90-120 days to complete the process.

PPO Reimbursement Negotiation from APEX

APEX Reimbursement Specialists can handle the credentialing process and negotiate with PPOs on your behalf. Contact our team today by calling (410) 710-6005. We look forward to working with you to make your practice a more profitable place.