The payer verification process can be the toughest, but critical, part of having a well-operating,
successful dental practice — at Capline Dental Services, we understand this. It would be the same as if
you were trying to see patients without the proper credentialing or driving a car without a license to do
so. We embark on a mission to demystify this complex process and guide you through the nuanced
terrain of dental provider credentialing with confidence and simplicity.
Dental provider credentialing is more than just a bureaucratic checkbox. It's a comprehensive
verification process where insurance companies and healthcare networks thoroughly examine a dental
professional's:
Provider credentialing is the process of verification of competency, and if the provider wants to start
early, the payers won't accept the application to begin credentialing. It typically takes 3 to 6 months or
longer as some plans do not want to expand their payment exposure.
It can be tricky that providers cannot see the patients with the insurance plans when credentialing is
done, as they will not receive reimbursement for any services rendered. The patient cannot get
treatment from an out-of-network provider if they carry insurance because the services will not be
covered.
Therefore, if approached carelessly or incorrectly, the process can lead to revenue loss. On the other
hand, the credentialing system can add benefits like increasing patient base, more services offered, free
advertising network through the insurance company, preferred provider by the insurance company, etc.
What to do while it is affecting the business?
Before diving into the payer credentialing process, dental providers must:
The heart of the dental provider credentialing journey involves:
This is a question we hear frequently at Capline Dental Services. The short answer is: that it's
complicated. While technically possible, it's not recommended. Here's why:
Insurance networks and payers will:
The payer credentialing process isn't overnight magic. Typical timelines include:
Providers often encounter obstacles such as:
We don't just process paperwork – we become your strategic credentialing partner. Our comprehensive
services include:
Leveraging cutting-edge technology, we streamline the payer credentialing process to:
Proper dental provider credentialing is an investment, not an expense. By partnering with us, you:
Ready to simplify your credentialing journey? Contact Capline Dental Services today. We transform a
complex process into a smooth, manageable pathway to professional success.
