FAQ's for Providers using CredentialConnect
Updated
by Laura Zapata
CredentialConnect FAQs
Where does one go to register for CredentialConnect Services?
CredentialConnect Services must be added to your DentalXChange account before the registration can take place. While logged in, see Add/Remove Packages under My Account or contact the Credentialing department at 1-800-576-6412 Ext. 471 for more information.
What is CredentialConnect?
CredentialConnect is a tool used to facilitate the credentialing process for offices and providers by offering readily available application forms for payers nationwide. This innovative software streamlines the data gathering process and enables providers to track the application process from start to finish. Providers answer a series of questions requested by each Payer, gathered through one easy to use application wizard. The answers are then used across multiple applications.
How is CredentialConnect helping practices?
CredentialConnect is helping practices to keep all of their provider credentialing needs in a centralized online account. It is helping practices save time as they can fill out multiple applications for a provider and for multiple payers at the same time. It also eliminates a lot of the work of reaching out to individual payers to request applications, and provides an easy-to-use platform for anyone, even those who have not done credentialing before.
How does CredentialConnect help payers?
Payers receive clean submissions with all required questions and certifications attached. Payers no longer have to reach out to the offices for additional information as submissions from DentalXChange are complete and ready for processing.
What information do I need to complete the applications on CredentialConnect?
In addition to practice and provider information, the following documents are most commonly required by all payers:
- W-9
- Dentist/Hygienist License
- DEA Certificate (if applicable)
- Diploma/Degree
- Board Certification/Specialty Certificate (for specialists)
- Malpractice Insurance
- Curriculum Vitae
- W-9
- Dentist/Hygienist License
- DEA Certificate (if applicable)
- Diploma/Degree
- Board Certification/Specialty Certificate (for specialists)
- Malpractice Insurance
- Curriculum Vitae
Can I save applications after I start and complete them at a later time?
Yes, CredentialConnect will save any existing data in the question wizard and remember where you left off.
What feedback have providers given after using CredentialConnect?
Providers report that the application process takes minimal time to complete now. Some share that they are able to complete applications in under 5 minutes! Clients are extremely happy that they are able to keep all of their credentialing needs in a centralized account and that CredentialConnect sends out reminders to them of expiring certifications and recredentialing due dates. Clients also report that using CredentialConnect is convenient as they no longer have to keep paper files and all credentialing history is stored within CredentialConnect.
Credentialing FAQs
What is credentialing?
Credentialing is the process of a provider entering into a contract with an insurance. Once the provider joins their network, they will be able to see patients that are a part of their network.
Why would a provider want to credential with a payer?
Being a credentialed provider with a payer means you are able to see patients who have specific insurance plans and bill those insurance companies for the services you render. This can greatly increase the number of patients you can service.
What is the process of getting credentialed with a payer?
You would need to complete your application and attach all required certifications within your CredentialConnect account. Once your application is complete and you have completed all required fields, you are required to submit your completed application to DentalXChange for processing. Once DentalXChange reviews your submitted application it is then forwarded to the payer for further processing.
Do I only have to credential one time?
Most payers require providers to renew their credentialing status through a process called recredentialing. Recredentialing is the process of periodically reviewing and re-verifying your professional credentials with a payer. The recredentialing period is typically every 3 years, but varies by payer.
Why do I have to recredential?
Recredentialing is required to ensure that the payer has the most up to date and accurate information about a provider. It is also an opportunity for you to update any changes in your practice location, phone number, name, etc. that may have changed since you were initially credentialed.
How can I update information if I'm already credentialed and not yet due for recredentialing?
CredentialConnect has network maintenance forms available that consist of other types of forms sometimes required by payers in order to update information for providers that are already credentialed. Network Maintenance form types include: Add Associate, Add Location, Change Request Forms, Direct Deposit Forms, Practice Purchase Forms, Terminate Associate Forms and Terminate Location Forms.
