Dental Insurance Credentialing

Dental Credentialing Service Company

Dental practices must get their dentists credentialed in order to participate with a myriad of insurance companies and their different plans. There are different types of insurance providers including PPO, HMO, DHMO, DMO, Medicaid and within each type, there are several insurance providers. Not only that there are further different plans offered by insurance providers. It can all get confusing very fast!

What is Dental Credentialing?

Dental credentialing is a process of verifying a dentist’s professional record. This includes verification of their career, education, training history, malpractice history, license verification and so on. Whenever a dentist applies for practice within a dental office, they are required to complete an application with important details that are asked for.

In simple terms, “Dental credentialing is defined as a process of getting enrolled in an insurance company’s preferred provider network.”

The Need for Dental Credentialing

Gone are the days when dental credentialing was considered an optional factor in the growth of a dental practice. Earlier, practices didn’t gave much importance to dental credentialing as far as growing their patient base was concerned but now times have changed and it has become extremely important for doctors to get credentialed. Patients are 90% more likely to seek treatment from providers who participate with their insurance plans. Not only do you increase opportunities with potential patients in your area, insurances offer listing services to boost you visibility online and in-network. The benefit for becoming a participating provider increases the opportunity to obtain new patients for your practice. This increases your overall potential and revenue stream.

Why Is Dental Credentialing Important for Growing a Practice?

Dental credentialing company is also referred to as “Provider Enrollment” or “Insurance Credentialing”. Dental credentialing has become a necessity because it is a procedure that allows patients to confidently place their trust in their chosen dental care provider. In addition to this, dental credentialing also allows dental practices to get linked with insurance companies so that they can accept third-party reimbursement. After being associated with an insurance company, you can easily become an in-network provider.

Getting credentialed with insurance firms has now become a necessity because most of the people in the US are covered by a dental insurance plan and they expect their dental service provider to accept their insurance. However, dental practices that are not in network with the patient’s dental insurance plan are at risk of losing their patients. This ultimately affects the revenue, patient base and bottom line of any dental practice.