1. Credentialing: Insurance companies verify your education, training and professional history to ensure you meet the necessary dental credentials requirements for an in-network provider.
2. Contracting: The insurance companies issue a participating provider agreement outlining specific terms for participation and receiving claim reimbursement.
The provider agreement is a requirement for in-network reimbursement, but it may be possible to bill as an out-of-network provider until the credentialing process is completed. However, the insurance company does not guarantee claim processing in this case, as acceptance depends on patient out-of-network benefits.
Here are the checklists and considerations to prepare for before beginning the credentialing process:
After completing the credentialing process you may begin billing for in-network services. Ensure proper insurance verification before treating any patient and submit claims within 24 hours through an efficient billing system for timely payment. Post the payment once received from the insurance company, and bill the patient or another insurance provider for the remaining balances due.
EZDDS offer the best dental insurance credentialing services to help you participate with insurance providers with extensive patient base for faster payments and better profits.