Credentialing 101: Understanding the Basics of Credentialing

One of the most tedious and arduous processes that many dental practices need to go through is credentialing. Unfortunately, it’s a task that every dental practice needs to complete for every insurance network that they participate in. APEX Reimbursement Specialists works with dentists like you every day to streamline and simplify the credentialing and recredentialing processes. What are the basics of credentialing every dentist should know?

What Is Dental Credentialing?

The best place to start when understanding the basics of credentialing is working to know what it is in the first place. Dental credentialing is how your practice enters into a formal contract with an insurance company. By doing so, you will become an in-network provider for that insurance company and have access to a larger patient base, which can increase revenue and your patient count. The credentialing process is very in-depth because insurance companies want to confirm that you are truly a practicing dentist in good standing. You will need to submit, among other things, proof of your degree, licensing, malpractice insurance and compliance.

Who Needs to Be Credentialed?

Another one of the basics of credentialing is understanding that every dentist will need to decide whether or not to be credentialed for every insurance company. If multiple doctors are within your practice, every individual can choose to be in-network (credentialed) or out of network (not credentialed) and which networks they would like to belong in. Even if every dentist at your practice would like to be in-network for one insurance company, all of them must be separately credentialed. You cannot use one application for your entire practice. 

How Can You Make It Easier?

APEX Reimbursement Specialists works with countless dental practices to help streamline the credentialing process. The paperwork required is very tedious and, because it must be completed for every dentist for every insurance company, it can take a great deal of time. We work with you to ensure your applications are properly completed and received by insurance companies, then we will complete all follow-up necessary until you are considered an in-network provider.

APEX Reimbursement Specialists Can Help With Your Credentialing

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.