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Starting a Dental Practice – Conquering The Dental Credentialing Dragon Right From The Beginning

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Starting a Dental Practice

Getting this right is the key to everything else in your practice falling into place. Here’s how you do it.

It’s the giant looming shadow in the room, right? The one unanswered question that’s keeping you from focusing on anything else. You’re not looking forward to dealing with it, but you’ve heard your colleagues talk about their success as a result of getting credentialed. You turn and look up at that King Kong-sized mountain in front of you wondering if you really want to attempt to conquer it.

 

That big beast is called dental credentialing and it’s just as intimidating in real life as it is in your mind. We wouldn’t be doing you a service to lie to you. It’s not easy, either. Fortunately, you have one thing going for you. You were smart enough to land here. And this is where we are going to break down the dental credentialing dragon piece by piece (just call us the mother- and father- of credentialing dragons).

 

By the end of this article, you’ll know exactly what the dental credentialing process is and how to get your practice through to the other side largely unscathed. Let’s get started, shall we?

Starting a Dental Practice

What is dental credentialing?

There are in-network dental insurance companies who offer an invitation to a dentist to become part of their network. An agreement is created between the parties and in exchange for abiding by their rules and regulations, an insurance company will admit a dentist into their network which exposes the dentist to the opportunity to gain new patients.

Should I get credentialed with a dental network?

Now, there’s no law that says you have to join a dental network. You could trot along in your dental practice acquiring new patients on your own. It would require a fair bit of marketing know-how, but you could do it. The problem that arises is that marketing is a long-term strategy. Joining a network could exponentially cut down that time, allowing you to obtain more patients faster. That is not to say that if you join a network you will never need to market your dental practice. Marketing is the lifeblood of every business. However, a network can really speed up the process.

For example, you would be listed on the insurance company’s website as a preferred provider. That would gain a lot of traction for your dental practice by itself because when patients go to the website, they’ll see your name and contact information listed in their area. This gives you a better than average chance of getting that patient to choose you.

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Which insurance companies should I credential with and why?

The dragon is in the details and that means that the type of dental insurance companies that should be on your short list of prospects are the ones who are in alignment with your own practice’s goals. This means that in order to know which providers will be a good fit for you, you must first know what you want from your dental practice. 

 

When that lizard is tamed, then you can search for insurance companies who align with your practice’s goals and start the dental credentialing process with them.

How do I begin the dental credentialing process with a dental network?

If you’ve never been through this process before, it’s best that you know that it’s going to be painful. Not a fire-breathing dragon whispering in your ear painful, but sometimes it may feel like it. Especially if you don’t know what you’re doing or worse– you put the process in the hands of others who don’t know what they’re doing. This is often the case with many dental practitioners. They assume their office staff can handle the responsibilities of the dental credentialing process and then are sorely mistaken when they realize they have to start the process all over again because of a missed deadline or an unsubmitted document.

 

To begin, you will submit your application. Once it is determined that your dental practice is in good standing, the paperwork process starts. This is usually the time when most start developing gray hair.

Why does the dental credentialing process take so long and what can I do to speed it up?

Typically the entire credentialing process can take anywhere from about 30-180 days with many variables all playing a part in the process. If there are mistakes made, it will delay the process and in many cases cause an application to start from the beginning. Note: this process is for EACH insurance company you’re applying to. Every network has their own rules and requires absolute compliance. The best thing you can do to speed up the process is to have all your paperwork properly filled out and ready to go as early as possible. Be as proactive and professional as possible. Anticipate the needs of the application process and provide documentation upon request. The more “together” you are, the likelihood of success.

When will I know I’ve been credentialed?

Here’s the bad news…. There’s no clear cut confirmation on the insurance company’s end. At least not for some time. You will have to do most of the legwork here. That includes following up repeatedly to make sure that everything you submit has been received and is processed. It’s very wise to create a calendaring system to remind yourself consistently when to call and ask about the next stage in the process every single time you submit anything. This is important because if there are any clerical errors or the correct paperwork wasn’t submitted, you’re going to want to know that as soon as possible so you can correct the problem. The worst thing you can do is not follow up and receive a denial letter because they didn’t receive the correct information from you.

 

You’ll want to make sure that you follow up with the insurance company every 30 days at least to ask about anything else they might need. When it comes to dental credentialing– anticipating their needs and following up regularly are the key to keeping the process moving forward.

Where do I go from here?

You have two choices right now– you can do all of the above yourself or leave it with office staff and pray they know what they’re doing. Or you can call us and let us walk you through our detailed system that has gotten other dental practices like yours credentialed seamlessly and smoothly. If you don’t like what we have to say, then there’s no harm done and we’ll part as friends. But at least give us a chance to demonstrate how much easier we can make life for you.

 If we were you, we’d give us a holler. You can reach us at here.

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