Insurance Credentialing Services in South Florida & across the U.S.A
Insurance Credentialing Services: Streamlining the Provider Enrollment Process Insurance credentialing services are a vital requirement for healthcare providers, mandated by dental insurance companies to validate and certify their professional qualifications, training, and legal accreditations. Whether you are a new practitioner joining a practice or an existing provider, this due diligence process involves validating and assessing your credentials through the gathering and authentication of academic documents, licenses, personal identification, background checks, and references.
For independent dentists in Florida and across the United States seeking to become participating providers with multiple dental insurance companies, the provider enrollment process can be overwhelming. In Florida alone, there are approximately 16 desirable dental insurance companies, each with its own competitive reimbursement fee schedules. The paperwork and documentation collection required to credential “one” dentist into a new practice can be extensive. Furthermore, once a dentist is contracted by a dental practice or healthcare organization, these accreditations must be validated and renewed annually to continue serving patients under each insurance plan. Each insurance company has its own specific application process and policies that must be meticulously followed by the dentist.
Credentialing involves a meticulous gathering of authentication documentation, making it a time-consuming and time-sensitive process. Deadlines for document submission vary across insurance plans, adding to the complexity. At HMS, we understand the challenges dental practices face and aim to alleviate the burden by handling the tedious tasks associated with insurance credentialing services. Our subcontractors work closely with dental offices in Florida and the United States, ensuring the collection of required documentation and following up with different dental insurance representatives. By saving precious administrative time, we enable dental practices to focus on patient care and revenue-generating tasks.
We assist dentists with their initial enrollment or renewal credentialing insurance agreements, collecting the necessary forms from dental insurance companies. We complete the enrollment forms on behalf of the dentist, with the exception of their signature. Once the dentists sign the enrollment application forms, as instructed by each dental insurance company, we submit them via email or fax. At HMS we take care of the deadlines with each Insurance application because in the event that requested documentation is not submitted within the designated timeframe, the healthcare professional may need to reapply and restart the provider enrollment process with a new enrollment form.
Our team maintains direct and daily communication with dental insurance representatives across Florida, ensuring accurate and expedient completion of all accreditation-related tasks. We follow up periodically with each dental insurance company to track the status of individual dentists’ enrollment credentialing requests. The results are shared with the dental practice’s manager through a comprehensive spreadsheet report. Upon completing 70% of the work, we issue a bill for 70% of the service charges. The remaining 30% is already submitted to the insurance companies and awaits their review and approval. Once the process is completed, we will submit a final bill for the balance of the remaining 30% accreditation process. We continually liaise with insurance companies to monitor the status of enrollment credentialing requests, ensuring a smooth and expedited process.
By entrusting your insurance credentialing needs to HMS, you can navigate the complexities of provider enrollment with confidence, knowing that our experienced team is dedicated to supporting your dental practice’s success in Florida and the United States.
Simplify your insurance credentialing process today with HMS’s expert services. Call Us Today