Credentialing is a process wherein insurance networks acquire and evaluate documentation regarding the training, work history, license and regulatory compliance record of a dental provider. This process is done and verified before the dental practice provider gets involved in treating patients.
To make the process smooth, efficient and quick, dentists must provide a list of verifications (Medicare and Medicaid) to insurance carriers. This makes them eligible for reimbursable expenses.
Not acquiring proper credentialing results in lost revenues. Insurance carriers do not accept or reimburse bills that have not been properly credentialed. Therefore, it is becoming quite difficult to credentialed because there are many dentists in the market competing for spaces on an insurance company panel. So, the most viable solution is to outsource credentialing services. Outsourcing the entire credentialing process reduces the burden of credentialing.
The process of getting a provider credentialed involves a lot of manual paperwork that includes completing the application form, providing clarification from payers and following up with them to resolve the credentialing request. This service is a true alternative to traditional paperwork that is quite slow and cumbersome process. It also eliminates the frustration with other steps in the credentialing process like:
Initial Application.
EFT Enrollment.
Timely follow ups with Networks on Credentialing status.
Status Reports of credentialing to facilities.
Notifications of renewals to providers.
Re-Credentialing.
Fee negotiation.
Capline’s credentialing services fit any dental office, be it large or small. Our staff keeps you up to date on the progress of your credentialing by allowing you to focus more on other important patient-related issues.
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