Why should I be credentialed in the first place?

Dental insurance and discount plan enrollment has increased exponentially in the past decade. This is due to the increased offerings of dental insurance by employers. Further, there has been a proliferation of dental insurance options and discount programs that have allowed patients to self-insure more than ever. Finally, the cost of dental treatment has continued to rise while incomes remain stable or in decline. Thus, the combination of increased insurance options and economic need has resulted in patients seeking in-network providers as opposed to their traditional family dentist. In other words, patients have had to think more with their pocketbooks as opposed to their hearts, loyalties or locales.

The dynamic between the rise of insurance and the increasing cost of dentistry the main reason why multi-practice dental organizations are dominating the industry. Their acceptance of insurance has resulted in the ability to capture the bulk of patients.

Being credentialed with insurance companies and discount programs allows you to compete more fairly in the industry and attract more patients.

In addition, insurance credentialing is the most inexpensive, high-yield marketing opportunity for any dentist out there. Your enrollment in these networks privileges you to advertisement on the insurance website and an opportunity to be selected by network patients. Network participation allows you save thousands of dollars in marketing while increasing your patient base.

Finally, credentialing grows your practice through patient referrals. A satisfied patient visiting your practice will not only share his or her experience to friends and co-workers, he or she will also share that you accept their insurance or discount program.

Why should I have Dentsential credential for me?

The answer to this is simple. Credentialing is a hassle. Credentialing is a very tedious process despite being the best thing you can do to increase your bottom line, grow your patient base and maintain current patient relationships. Every insurance company has different requirements, different paperwork and different response timelines. Also, different insurance companies can have such a dizzying array of options making it hard to know what to choose.

From start to finish, it can take more than 40 hours plus to complete the credentialing process for the common insurance companies. Isn’t that time best reserved for patients, training your staff on patient care and generating revenue? A single hour of paperwork could have been a crown!

Finally, we are experienced in the credentialing process. Our team has experience with major and minor insurance, discount and even state funded plans. Why not let us do the heavy lifting for you? If you have done it before, you know the challenge.

Can I just get the credentialing services without the analysis?

Absolutely! We offer comprehensive services because we believe one-size does not fit all. Thus, we offer our per plan option where you choose the plans and we do the credentialing paperwork for you.

Can I get credential services for state-funded plans and HMO?

Yes. We offer comprehensive credentialing services because different practices have different needs.

How long does the credentialing process take?

The process can take anywhere from 30 to 120 days from start to finish depending on insurance company and document turnaround. Some companies get you credentialed quickly, while others take much longer. Fee negotiation can go a little longer, but are well worth the wait.

What does “selective participation” mean?

There is a wider variety of dental plan options now more than ever before. However, not every insurance company and discount plan is equal. Not all have significant numbers of patients enrolled and not offer advantageous fees. Therefore, a selective approach for plan participation may be preferable to a dentist because it offers him or her ability to choose the best plans for his or her practice. Selective participation is a good choice for those dentists looking to balance a thriving fee-for-service market with profitable insurance options. It is also a good choice for dentists seeking to ease into the insurance world more strategically.

What does “participation maximization” mean?

Participation maximization is a strategy where a dentist seeks to join most, if not all, available networks in order to accelerate practice growth and rapidly grow his or her patient base. It is the view that many networks leads to many patients. Participation maximization is suitable for the aggressive solo dentist or group practice looking to expand to multiple locations or looking to dominate the insurance and discount plan market.

Participation maximization is the strategy utilized by most large-scale dental organization, but it is just as valuable to small practices looking to stay relevant and competitive. It is especially valuable to the new dentist looking to quickly improve cash flow without the expense of traditional marketing.

Further, maximizing participation allows you to keep patients because employers often switch plans from year to year. Thus, you do not lose the patient whose employer switched from Delta to Metlife during the enrollment period.

What is fee negotiation?

In exchange for entering an insurance or discount plan network, a provider must only charge the patient the maximum allowable fee for any dental procedure. You are provided a fee schedule when you join and network. This fee schedule is often less than your UCR (i.e., cash fee).

Insurance fee schedule are not as static as people often believe. Many insurance companies are willing to negotiate a fee schedule with a provider. Factors such as location and simple negotiation skills are considered in adjusting fees. Fee negotiation can result in more desirable fees and improve your bottom line by thousands.

At Dentsential, we utilize our experience in strategic fee negotiation to seek out the best possible fees for your practice. Not all plans negotiate, but many are willing.

Please contact us if you should have any additional questions.