Dentists and owners of dental practices find it hard to be credentialed by dental insurance. They handle patient care, administration and day to day operations. The owners of dental practices are scarcely able to take 40-60 hours per provider to fill their applications to their credentialing. However, when your practice lacks the appropriate credentials, it cannot participate in insurance networks. It also implies that you do not have access to people in the network or can be compensated by them, which makes the financial development and the success of your practice unreliable. 

Dental credentialing has become a very complicated area. CAQH profiles should be fully correct and updated. PPO networks have very rigid eligibility criteria to providers who wish to join. The Medicaid dental programs of each state screen the applications in different ways. It may take up to 120 days or even more time to acquire credentials in case of a mistake or delayed paperwork in the application. Considering dental practices, be it opening their first dental office, the addition of an associate dentist, or a multilocation, professional credentialing service, it will turn the entire administrative load into a streamlined procedure. 

The best credentialing firms of dentists due to their services and knowledge are distinguished in the competitive dental credentialing market. Be it as a solo practitioner, multi-specialty dental group, or dental service organization with multiple locations, it is important to select the credentialing partner that would speed up entry into the network and earning revenue.  

Why Dental Credentialing Are Essential 

Dental credentialing serves as the gateway to insurance network participation.  

Prior to full credentialing, dentists are able to treat patients as out-of-network providers only, which means that patients will pay more, collections will be more difficult, and patient volumes will reduce. The in-network providers are chosen by most patients because their out-of-pocket costs are less, and therefore credentialing is critical to the growth and survival of the practice. 

Credentialing can be used to assure that dentists are within the standards of the government and insurance firms. This is accomplished by examining their academic records of dental school records, state licensure, register of registered nurses, medical insurance, and work experience. This evidence keeps patients and payers secure and instills confidence in the capability of providers.  

Income of providers is directly affected by proper credentialing. The insurance network negotiates schedules of fees to dentists, which ensure levels of payment. Conversely, non-network dentists are likely to be faced with extended patient waits and unpredictable payment. Insurance companies can reject or postpone the claims provided by the providers who do not present the qualifying credentials regardless of the quality of their service provision.  

Compliance with regulations needs constant attention. Licenses that have expired, liability insurance that has elapsed, or CAQH accounts that are outdated will immediately restrict payment flows. Professional certification services keep an eye on these rules to make sure they cannot hurt the practice’s image and cause revenue issues. 

How to Choose the Right Dental Credentialing Company 

Credentialing for dentists is very different from other medical credentialing services. Look for companies that have a history of working with dental practices, not just healthcare providers in general. Companies that know about dental PPOs, DMOs, Medicaid dental programs, and dental-specific coding understand the intricacies that general credentialing companies often miss. 

CAQH Enrollment Knowledge: Over 100,000 dentists use CAQH for credentialing data exchange for dental plans. Your credentialing partner must demonstrate deep CAQH expertise, which includes profile creation, requirements attestation, documentation upload, and ongoing maintenance. Companies that don’t prioritize proficiency in using CAQH will cause delays affecting your entire network enrollment. 

Pricing, Efficiency, and Support: Evaluate pricing transparency, as reputable companies provide clear fee structures without hidden charges. Assess typical turnaround time, with reliable companies completing the credentialing process in 60-90 days for most networks. Additionally, examine support models, standard communication, and progress updates as they prove essential during such lengthy processes. 

Compliance Expertise: Dental credentialing involves state-specific regulations, insurance company requirements, and federal insurance programs like Medicare and Medicaid. Your credentialing partner must stay current with changing requirements, ensure complete applications, and maintain audit-ready documentation protecting your practice during regulatory reviews. 

Top 10 Best Credentialing Companies for Dental Practices 

CredexHealthcare 

Credex Healthcare brings comprehensive medical and dental credentialing expertise that serves dental practices nationwide. While known primarily for physician credentialing, Credex has expanded services to support dental practices needing both insurance credentialing and comprehensive practice management support. 

Overview:  

Based in Florida, Credex provides personalized credentialing services through dedicated specialists assigned to each dental practice. This personalization ensures that there is an expert who manages all your credentialing activities and is familiar with your specific practice. 

Dental Credentialing Services:  

Complete CAQH profile creation and maintenance, PPO network credentialing (Delta Dental, MetLife, Cigna, Aetna, UnitedHealthcare), state Medicaid dental program enrollment, Medicare credentialing for dentists providing covered services, dental specialty credentialing, multi-location credentialing coordination, recredentialing management, and ongoing compliance monitoring 

Why Choose Them:  

Credex’s integrated approach handles both initial credentialing and ongoing maintenance, preventing lapses that interrupt billing. Their dedicated specialist model provides personalized attention that large national firms cannot match. For dental groups needing credentialing for multiple providers across various locations, Credex coordinates complex enrollments efficiently. 

Best For:  

Solo dental practitioners, multi-doctor dental groups, dental specialty practices, practices expanding to multiple locations, startup dental offices. 

CureMD Dental Credentialing 

CureMD provides specialized dentistry credentialing services that make it easier for payers to sign up and get rid of unnecessary administrative tasks. Their reliable staff speeds up applications with major insurance companies, dental boards, and credentialing authorities so dentists can start taking on patients and processing claims faster. 

With proactive communication and regular updates, CureMD ensures dentists always know their credentialing status. They help dental practices get Medicare and Medicaid approvals quickly for low-income and senior customers, and they handle DMEPOS registration for dental providers who provide dentures and oral prosthetics. 

eAssistDental (Unitas) 

eAssist, powered by Unitas, specializes in dental practice management, including comprehensive credentialing services. They take the credentialing process off your plate entirely, ensuring dentists are enrolled fast, correctly, and profitably.  

eAssist offers credentialing to dentists accurately while assisting practices in selecting the best PPO plans to join based on regional cost analysis and market research. Their staff manages every application from start to completion, providing real-time information. They customize pricing depending on monthly collections and service requirements, ensuring transparancy with no hidden expenses. 

PPO Experts

PPO Experts brings specialized expertise in dental PPO credentialing and fee negotiation services. They fully credential dentistry offices by utilizing efficient workflows that cut the credentialing process by up to 30 days. 

PPO Experts does more than just simple credentialing. They also check regional fee analysis, find the best businesses and companies in your market so that they can credential with their insurance plans, and conduct Medicaid credentialing for all local programs. By getting better PPO fee plans, their consultation services help practices boost production by 3 to 5 percent. 

Capline Dental Services 

Capline Dental Services reduces credentialing burden by taking full responsibility for credentialing paperwork. Their experts in dentistry credentialing work directly with practices to organize the specific documentation needed to make the registration process faster.  

Capline uses a simple but effective process in collecting information by using private digital forms to collect information and send in registration applications. They also keep in touch with insurance companies on a regular basis during the enrollment process. They help PPOs, DMOs, DHMOs, and HMOs get credentialed and offer payment plans with affordable prices. 

Medusind Dental Credentialing 

Medusind brings years of industry expertise helping dental practices maintain their patient lists from major insurers. Their experienced credentialing team ensure accurate and complete application submissions, which reduces the chances of resubmissions and minimize approval wait times.   

Medusind understands that credentialing takes 90-120 days minimum, often longer with resubmissions. Sending in correct applications the first time is very important for making the business thrive and be productive. Their simplified processes cut approval wait times significantly, make routine work easier, and help practices attract more patients. 

Fluent Dental (Delegated DDS)

Fluent Dental also provides delegated credentialing under the subsidiary Delegated DDS. Such services cover a complete range of credentialing, recredentialing, and continuous quality monitoring of dental providers. They have the best skills in securing providers in faster ways via tech-enabled services and direct-deal delegation with dental insurance companies.   

Delegated DDS can be used by dental insurance companies and DSOs to provide them with experienced partners and tested and proven processes that ensure that administrative work is much easier and the credentialing wait times are considerably reduced. They have a credentialing staff who are well-learned, helpful, and reliable, which makes them an excellent option for all your credentialing requirements. 

Transcure

Transcure serves healthcare providers across multiple specialties, including dental practices. Their reliable credentialing experts and high customer retention rate reflect commitment to quality service. The company offers integrated credentialing services with end-to-end revenue cycle management.    

They handle CAQH profile management, state Medicaid dental enrollment, PPO credentialing, and ongoing recredentialing. Their 24/7 service availability enables dental clinics to operate after hours while offering proactive communication throughout the credentialing process. 

Benefits of Professional Dental Credentialing 

Professional dental credentialing is highly beneficial for dentists and dental practices across the U.S.  

Faster Provider Enrollment

Professional credentialing companies can enroll providers in 60 to 90 days, while self-managed credentialing takes 4 to 6 months or more. Their extensive knowledge keeps them from making common mistakes that lead to rejects and resubmissions, which add more processing time. 

Reduced Compliance Risks

Credentialing experts ensure that all applications meet all insurance company and government requirements. They do this by keeping and organizing digital records so that they can be audited accordingly, and we can avoid compliance issues that could affect insurance network enrollment. 

Insurance Network Access

Expert and experienced credentialing professionals know which networks work best for different types of practices and locations. They help dentists join networks that generate significant income while staying away from ones with unfavorable fee plans or too much paperwork. 

Efficient Billing and Reimbursement

Proper credentialing enables clean claims submission without any delays. When credentialing information perfectly matches insurance records, claims are processed without delays, accelerating revenue cycles and improving cash flow. 

Conclusion 

Dental credentialing doesn’t have to take up much of your time or keep you from seeing insured patients for too long. Businesses that specialize in professional credentialing have knowledge, developed relationships with insurance companies, and a fast process that reduces credentialing periods considerably and ensures that they are appropriate and satisfy the requirements. Professional credentialing services can assist you in becoming a member of a network and earning income more quickly, regardless of whether you just started your first dental office, have partner physicians, or have many offices. 

At Credex Healthcare, we understand that dental practices need credentialing partners who combine dental-specific expertise with personalized service and ongoing support. Our experienced credentialing experts act as your practice extensions to ensure that you can join the appropriate insurance networks within the shortest possible time without any failure to comply with the legal requirements. 

Ready to streamline your dental credentialing? Contact Credex Healthcare today for a free consultation.  

FAQs 

What is dental credentialing? 

Dental credentialing is the process that insurance companies use to make sure that dentists meet certain requirements, such as documents that prove their education, license, training, and work background, before letting them join a network and pay claims.  

How long does it take to credential a dental provider? 

Most insurance networks can get dental providers credentialed in 60 to 90 days with professional credentialing services. However, some networks can take up to 120 days, based on how fast they process applications.  

Do credentialing companies handle CAQH enrollment? 

Yes, reliable dentistry credentialing companies create CAQH accounts, upload all the relevant papers, confirm them, and maintain them up to date so that all insurance companies can consider them for enrollment. 

Are credentialing services costly? 

Dental credentialing services normally cost between $500 and $2,000 per provider, depending on the size, number of networks, and complexity of the process. This investment cuts down on staff time by 40 to 60 hours and speeds up the registration procedure. 

Can small dental practices use these services? 

Yes, credentialing services are highly useful for small dental practices that don’t have the administrative personnel to undertake the difficult credentialing procedure on their own. Any size of a dental clinic, from a one-person startup to a large group of dentists, may utilize these services.