Dental Credentialing Services Company PPO, HMO, DHMO, DMO, Medicaid, CHIP

Dental Credentialing

Dental Credentialing Services 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!

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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.

What Is the Process of Dental Credentialing? What All Documents Are Required?

The process of getting credentialed is both lengthy and challenging. This complex and time-consuming process often comes across as a barrier to patient care. While dentists are engaged in a tedious, paper-based credentialing process, their patients are left neglected.

At Capline Dental Services, we can help reduce the burden by taking the entire responsibility of paperwork related to credentialing. We follow a simple yet smooth process. Our dental credentialing experts work with your practice and assist in organizing the detailed information that is required to facilitate the enrollment process. We take the information from you and start working on it immediately. Our experts won’t drop out until they get everything done the right way.

The provider’s documents required for verification are:

  • Dental School information
  • Board Certifications
  • CV
  • Dental License
  • Malpractice Insurance
  • Documents Related to Internship or Fellowship

Credentialing Process

1Create Your ProfileWe gather your information via a simple and secure online form.
2Submit Enrollment ApplicationsOur specialists prepare and submit enrollment applications.
3Negotiate Fee ScheduleWhere possible we help you negotiate better fee schedule with the insurance providers.
4Follow-UpWe follow up regularly with insurance companies to ensure proper handling of your applications, and work with them throughout the enrollment process so that you get in their network as fast as possible.
5ReportingWe provide weekly status updates and reports on each enrollment application and keep you updated all the time.

How Long the Dental Credentialing Process Takes?

Getting credentialed takes 3-4 months of time because there is too much involved in the process. In addition to submitting the required paperwork, there are other steps that need to be fulfilled for getting credentialing accurate and error-free.

Our dental credentialing experts totally understand that a simple error in handling the clutter of paperwork can allow a dentist with an expired license to continue their practice. This can lead to some serious complications as far as patient’s safety is concerned. Therefore, we are here to focus on your paperwork so that you can keep your focus on your patients.

Let us take care of your dental credentialing services so that your team can dedicate more time on important tasks of building a healthy schedule, advanced treatment planning, managing staff members effectively, and delivering a better patient experience. We will prepare and send applications and follow them up with the insurance companies.

What Is Dental Recredentialing?

Dental Recredentialing is a process in which the dental provider is re-evaluated. Dental Recredentialing can be done in every 2-3 years or frequently depending upon the requirement. A dental recredentialing process done accurately helps dental practices to deliver secure and high-quality care to their patients.

Failing to re-credential can cause quite a bit of hassle and inconvenience for you. If you continue to see clients after your agreement with the insurance panel has expired, you may be removed from the panel or even locked out permanently. Additionally, you will not be reimbursed for any services you provide during this period of time.

How Outsourcing Dental Credentialing Service Can Help?

A large amount of paperwork involved in the process of dental credentialing makes it highly time-consuming. By outsourcing dental credentialing services to us, you will be able to reduce the burden on your staff.

If you lack the expertise and understanding to operate the dental credentialing process, our Credentialing experts can be of great help. Our provider enrollment services can help you get enrolled with the insurance carrier’s network. This saves your staff’s time and lets them focus on what’s most important, i.e. patient care.

With a team of professionals having talent in getting you credentialed without any hassle, your practice could be saved from any kind of financial loss.

Our Dental credentialing company has helped practices improve cash flow. We manage the entire dental credentialing process for you and perform all the follow-up. By hiring us for your credentialing needs, you can be rest assured that credentialing will be done efficiently, thereby saving you time and money.

What Services Do We Cover Under Dental Credentialing?

  • Initial Credentialing
  • EFT Enrollment
  • Timely Follow-Up With Insurance for Status of Your Application
  • Status Reports of Credentialing to Providers/Offices
  • Recredentialing
  • Fee Negotiation

Why Choose Us for Dental Credentialing Services?

The process for dental credentialing requires a lot of paperwork and follow-up and some expertise. It demands your team’s frequent attention and takes away its valuable time. It involves tracking the applications at times over several months with insurance companies and follow-up too. Most dental offices find dental credentialing services burdensome and a distraction from providing the best dental care to patients. Often the result is that you may have to put up with delays and your providers not participating with the desired insurance.

By choosing our dental credentialing company, you will be benefited with:

  • Updates on credentialing status within 24 hours
  • Save time by letting us do all the paperwork for you
  • Revalidated applications even when your submission got returned due to errors
  • Our experts will complete your medicare enrollment thoroughly
  • We can get you in-network with insurance providers like, PPOs, DMOs/DHMOs/HMOs, Discount Plans, Medicaid and CHIP (Children’s Health Insurance Program)
  • Dental credentialing services offered by us are extremely competitive and carry a cost advantage over in-house dental credentialing arrangements that you may have

Give us a call at 888-666-0604 to receive a consultation with our team of credentialing experts. We have the expertise, time and resources to help you with this complicated process. Our experts will develop strategies to yield desirable reimbursement from each payer and maximize revenue for your practice.

Client Testimonials


We recently opened our dental office and appreciate the services provided by Capline Dental Services. It has helped us to establish ourselves rather quickly. Great job!


Maria HernandezSmilepoint Dental



Kudos to your team. We appreciate your fast response and thanks for improving our AR. I would not hesitate to recommend you all.


Jessica GarciaCrosby Family Dental



Thanks to Capline Dental Services for taking care of our Billing, Insurance Verification and Credentialing for our office since the past six months. That has helped our office to focus on our patients so much more.


Kimberly CanoLavaca Dental