Current dental practice trends show a shift toward multi-doctor or group practices instead of the traditional solo practitioner model. With this shift comes an increase in credentialing requirements, which many dentists may overlook when bringing on a new associate. It is important to be proactive when credentialing a new associate dentist.
Adding an associate dentist
When a new associate dentist joins the practice, inform all payers linked to your patient base, both in- and out-of-network. Update the practice’s billing entity information, name(s) changes, or formation of a new billing entity, if applicable to the situation.
An NPI number, along with a completed W-9 Form, should be obtained by the associate. Ensure that the information associated with the NPI number matches the credentialing documents to avoid payment delays or having the payment processed as “out-of-network” and sent directly to the patient.
Provide the new credentialing information to all payers before seeing patients. It may take a few weeks or more to process the information into the insurance company’s system.
In advance of patient care, the new associate should be familiar with the PPO contracts and the processing manual of each payer to understand the terms of service and payment.
Notifying the out-of-network provider relations department will help to prevent delays in payments associated with the new associate as the provider of services.
Removing an associate dentist
This same process needs to be completed when an associate leaves the practice. Correcting a payment to the wrong billing entity can take weeks because it involves a stop payment, a payment reissue, and any other corrections to the credentialing document.
Being proactive with credentialing helps you maximize income and avoid unnecessary headaches and stress. If you struggle with credentialing, consider partnering with Unitas. They streamline this process, ensuring your practice is credentialed swiftly and accurately. Schedule a consultation today.
