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
