Credentialing - Why?

The first question most doctors ask is why does the insurance company make me go through this annoying and timecomsuming process of submitting all this paperwork to be credential/recredentialed?

The answer is that once you're in their network (and published in their directories), they are, in effect, referring patients to you. Although the reason is basically that you agree to accept whatever compensation that network pays, they are also, in effect, endorsing you as a practitioner.

And before they do that, they want to make sure (and in some venues are required) to confirm that you have the necessary licenses and have no type of history that could impact the relationship with you, them and their subscribers.

Next post we'll look at the more commonly requested documents.

Another post will discuss CVO's and the part they play.

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Visit us at The Huskin Group about our dental insurance and practice management services.

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