It is vital for any dental practice offering dental care services to sustain a clean & updated team of dental practitioners. Dental credentialing is one of the measures needed by the practice to help serve and satisfy patients. It is an important process that gets dental practitioners from a practice approved by an insurance organization. This helps the practice to become an in-network provider by having the qualifications confirmed while also ensuring they uphold all the essential standards for patient care.
A dental credentialing company can assist a practice by verifying the team with several insurance organizations and their respective plans. It is not easy to deal with a multitude of companies and manage documentation accurately. One must note that insurance providers include DMO, PPO, HMO, etc, and there are various insurance organizations within these categories.
Here is where automated credentialing can make a difference. It is a process in which a dental practice completes an enrolment application electronically. Even today, a relatively large number of practices have not made the switch to automation and still complete the credentialing process through paper-based credentialing applications.
While the impact of automation and even artificial intelligence is being felt across multiple industries and consumer behaviour, the dental credentialing process will be impacted shortly. Some observations on how automation and AI are making an impact:
Automation in the credentialing process can lower the administrative cost of running the process for the dental practice. There is some resistance to adoption, even though dental plans offer an option for electronic and paper-based enrollment applications.
For some dental practices, a paper enrollment application may still be opted for due to the comfort of maintaining the status quo and avoiding the hassles of remembering usernames and passwords for multiple platforms across insurance companies and their plans.
The dental credentialing process has stayed the same for years. While the dental care industry is slow to adapt to modern technologies, the credentialing process has witnessed more takers in the recent past.
The credentialing process generally takes between a month and 6 months to complete. It requires multiple forms to be filled out and submitted. The insurance company needs to screen all the documentation to ensure that a dental practitioner
who gets credentialled can serve patients within their network to everyone’s satisfaction.
Since this process is time-consuming, there is a chance of errors while making submissions. It can be errors of commission or omission. The team might apply to multiple insurance companies at the same time, or it might successfully negotiate a fee schedule that is not in its best interest. It might also begin the credentialing process too late or send submissions with the wrong information.
As credentialing can be a slow and painful process, many practices are now seeking to go in for a makeover and embrace the opportunities that automation brings to make the process swift and with little room for error.
A lot of automated credentialing services offer dental practices a cost-efficient and secure enrollment administration process. This runs across interactions with call centres, data collection, data entry, integration, and analytics.
Automation applies to dental practices of all sizes. Moreover, it offers convenience in monitoring the process. The team can access the latest view of the credentialing status through dashboards at any given time. As a result, one can complete the credentialing process well ahead of its due date. The team can avoid delays in providing treatment and billing.
Automating the credentialing process can offer the dental practice a competitive edge. It is an unpaid promotional tool, as the practice will be listed on the insurance organization’s website as a preferred service provider. When potential patients are covered by insurance search on the website, the practice gets viewed and can be considered by the patient.
When the practice gets credentialed across multiple insurance companies, it gets exposed to a vast number of patients. A larger pool of patients can result in greater publicity and revenue for the practice.
When credentialing and re-credentialing get automated, the speed of getting enrolled gets accelerated, and the status remains uninterrupted, respectively. This acts as a competitive edge for the business compared to the traditional paper-based credentialing process. This edge attained through automation also opens possibilities for upgrading clinical equipment or even business expansion.
A few instances of how automation can make a big jump in getting dental practitioners credentialed faster and more efficiently.
Primary source verifications can be done instantly. Through advanced software, the entire practice can complete primary source verifications. This is possible through a direct integration to NPDB, CAQH, NPI, etc., along with a list of sanctions and exclusions.
Automated packet completion gets done faster. The dental team can compile credentialing packets with a single button click. This can help to reduce or eliminate manual processes that are prone to errors. This enables the dental professional to treat patients sooner.
The dental team does not need to worry about compliance norms as these automated solutions handle all workflows, source integration, audit logs, and other requirements.
Greater efficiencies in credentialing through automation reduce the waiting period for dental professionals to treat patients.
Insurance companies insist on credentialing and re-credentialing dental practitioners to render treatment and services to patients. Such a demand can be challenging and time-consuming. It also places a burden on the dental team and can harm the patient experience offered by the practice.
Some successful dental practices have now switched to AI. This move can help the entire team reduce the hassles associated with the credentialing process.
The incorporation of AI in the process helps to automate all data verification requirements while minimizing errors to a minimum. These elements would slow down the credentialing process. Today, a dental practice can profit through an AAI-enabled process by onboarding dental practitioners faster, thus enabling the team to focus on patient care.
A dental practice can treat patients much faster without waiting for as long a period as before. A practice can hire dental professionals and move them into their new positions much faster without getting trapped in administrative delays. AI enables a dental practice to become an in-network provider faster and ensures that the time saved can be used to build trust with patients. It also makes a dental practice appreciative of insurance organizations that value such a smooth and seamless credentialing process.
The dynamic and competitive landscape of the dental care industry, along with the quantum of credentialing requirements, makes automation a natural choice for a dental practice to stay competitive. Automation helps to streamline the operational and administrative workload while also enhancing overall efficiency in the
credentialing process. This also results in a greater pool of patients and higher revenues.
