Top 5 Reasons

to Outsource Credentialing

By Shelley DeGroff, Founder of PPO Advisors

To participate in various insurance networks, dental providers must be credentialed, a process that is cumbersome and requires copious paperwork, including proof of education, residency, training, work history, licenses and if applicable, specialty certificates and malpractice history. To stay in network, providers must repeat the process every 2-3 years, and if they accidentally miss the recredentialing deadline, they will fall out of network, which will result in lost revenue.

For years I was an office manager at several dental practices, so I know first-hand how hard it is to stay on top of recredentialing. That’s why PPO Advisors created Credentialing Access Point (CAP), a cloud-based system that not only makes it easier to manage the process by saving time and money but also spares staff a lot of headaches. Here are five reasons why dental providers should outsource the recredentialing process.

#1 Avoid Missed Deadlines

If you’ve ever failed to recredential simply because you missed the deadline, you’re not alone. Even if it’s unintentional, falling out of network is a serious problem and will end up costing you. Maybe you have new staff who aren’t familiar with the process or maybe your current staff is just too busy to keep track. Insurance companies don’t make it any easier by sending out reminders that look like junk mail which may get tossed without even being opened. By outsourcing, you avoid the risk altogether. We track the schedule, send reminders, and make sure all the paperwork is submitted on time.

#2 Reduce Staff Stress

The credentialing process is time-consuming and puts a significant burden on your staff. If you don’t believe me, just ask your administrative team. Their days are already packed with responsibilities, and when the time comes to recredential, it can be a real challenge to get it all done. By outsourcing you benefit from an experienced and knowledgeable team that knows the process inside out. We know exactly what needs to be done, how to do it, and can take advantage of under-utilized shortcuts for speeding things up. Most importantly, you can be confident that the process will be handled correctly, leaving you and your team more time to focus on patient care.

#3 Improve Accuracy & Efficiency

By capturing the efficiencies of automation, our cloud-based system reduces the potential for errors that frequently occur with manual processes that usually rely on spreadsheets, paper documents, and checklists spread over different departments. CAP creates a place to store the many documents required for credentialing. The cloud-based systems make it easy to verify and update, and check for errors.

#4 Better Fee Schedule

If you automatically recredential without taking time to review the terms of your new contract, you may miss an opportunity to get a better deal. By outsourcing, you gain the benefit of an experienced advocate who will evaluate your contract and determine whether you should renew, renegotiate or contemplate other options. If our analysis indicates it’s time to negotiate or look for a better contract elsewhere, PPO Advisors can utilize the recredentialing window to work on your behalf.

#5 Get The Support You Need

When you outsource, you can choose how much support you’d like. By opting for our CAP Essential Access, you’ll receive access to our cloud-based tool that tracks all the information you need such as licenses, fee schedules, and deadline reminders. You’ll also receive CAP Support, access to an experienced and knowledgeable advocate who is always available to answer questions and provide guidance. If you’d like more help, we offer CAP Ultimate Access, a service level where our team handles the entire application process for you.

Recredentialing Simplified

PPO Advisors has completed over 12,000 credentialing applications and we’re ready to put our expertise to work on behalf of your practice. If you have questions about credentialing or would like to learn more about how we can help you, contact us today.

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