Practice Management

According to Benjamin Franklin, the only two certain things in life are death and taxes. In the dental industry, there’s one more certain thing—recredentialing. This process occurs every 2-3 years for every insurance provider at every dental practice. While it might sound straightforward, the recredentialing process can be surprisingly tedious and complex. Every year, we work with dentists who believe a wide range of misconceptions about the process, the deadlines involved and how to complete it. 

What Is Recredentialing?

Recredentialing is a process every insurance provider requires to ensure that all participating dental providers meet the same qualification criteria as the last time that credentialing or recredentialing took place. Every dental practice needs to complete the process for every insurance network that they are a part of. Unfortunately, the experience can be lengthy and require a good deal of follow-up to make sure that the paperwork was received, processed and accepted.

Recredentialing is not the only opportunity for your practice to negotiate reimbursement rates. It should also not be seen as a one-time paperwork process that won’t need to be completed again. The process is tedious and involved, which is why many dental practices choose to partner with experts like APEX Reimbursement Specialists. 

The Biggest Recredentialing Misconceptions and Mistakes

  1. Ignoring Follow-Up: Most dental practices complete paperwork, mail it to the insurance provider and assume that it was processed and accepted. Forgetting the follow-up is a huge mistake. When you work with a credentialing specialist, follow-up will be automatically completed. We will touch base with each provider to make sure that the application was received, everything was included and it was accepted. If you fail to follow-up, your practice will be subject to the new version of the provider agreement and the newest reimbursement schedule.
  2. Skipping Steps: Recredentialing can require a great deal of paperwork, and your office needs to have all of the right documentation gathered together to submit. Many insurance companies are overwhelmed and will not track you down if you forget to include something. You’ll find out that you are no longer in-network when you try to submit a claim!
  3. Timing: The recredentialing process starts the day that you become part of an insurance network, not the day that your office opens or you relocate. If you are unsure of when you should recredential, you should always work with a specialist to stay on track and maintain compliance.

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.