TIN Change Management:

• Verify provider network participation
• Complete required TIN change forms

Credentialing:

• Unlimited dental carrier credentialing, re-credentialing and documentation to add, delete and change participation in all plans
• Create central digital storage location for all provider information. Identify any missing information needed for credentialing. Ensure provider participation by plan in each office
• Oversight of compliance by provider of state license, DEA, and other required certificates to ensure compliance

PPO Insurance Negotiation:

• Verify accuracy of current fee schedules per provider.
• Negotiate with insurance carriers on client’s behalf to secure higher reimbursement levels.
• Provide a detailed recommendation illustrating increases per code schedule.
• Upon receipt of approved recommendation ensure implementation of effective date.

UCR Review:

• Generate and deliver a UCR report detailing ADA code fees in desired zip code.

EFT Set Up & Transition:

• Contact insurance companies to verify required documentation/portal needed
• Complete relevant forms and/or assist the office in completing carrier specific portals

EOB Validation:

• Verify that providers are accessing correct carrier relationships through a sample set of EOBs
• Verify that the fee schedule they are being paid on is what they are being paid on