Are yOU being buried in a mountain of paperwork?
PPO credentialing takes 10-20 hours of your staff's time and 30-120 days of waiting. One mistake can delay enrollment for months.
Five Lakes Dental Practice Solutions handles everything. We get you enrolled in the right networks faster, without the busywork.
Our Track Record:
- 5,000+ applications handled annually
- 6,000+ dental offices helped since 2010
- 50 states – nationwide service
Simplify Dental Credentialing with a Strategic Approach
Dental credentialing is the cornerstone of your practice’s financial success. Being out-of-network or incorrectly credentialed can cost your practice thousands in lost revenue, damage patient relationships, and create billing headaches.
Dental PPO credentialing is complex. One wrong form or missed deadline can delay enrollment for months.
From collecting the correct paperwork, completing tedious applications, and following applications through to approval, your team members spend 10-20 hours per dental network… waiting 30-120 days for approval. This effort pulls them away from high-value tasks like patient care and practice growth.
At Five Lakes, we provide strategic dental credentialing services for dental practices, group practices, and DSOs. We credential your dental practice in the right networks with the optimal fee schedules.
What Makes Our Dental PPO Credentialing Different
- PPO Network Analysis: We don’t just submit forms. Our team will help you select which PPO networks will generate the highest ROI for your specific location and specialty.
- Fee Schedule Negotiation: After credentialing, we review and negotiate your proposed fee schedules – often securing 10-20% higher reimbursements.
- DSO & Group Credentialing: For multi-location practices, we centralize PPO applications and maintain consistent participation across all sites.
Our 7-Step PPO Credentialing Process: What to Expect
An important part of setting up your practice for success is to have a comprehensive understanding of what is around you. Five Lakes offers services for new and existing practices to analyze important factors that will affect the potential growth of their business. This comprehensive evaluation is the foundation for creating a business strategy designed to maximize your revenue cycle management and patient flow.
Gather Required Documentation:
Prepare all necessary documents, which typically includes state licenses and liability insurance.
Complete and Submit Application:
Fill out insurer-specific credentialing applications, which may be available via online portals or paper forms. Many insurers use the CAQH (Council for Affordable Quality Healthcare) database to streamline the process. We recommend maintaining an up-to-date CAQH profile.
Primary Source Verification:
Insurers must conduct primary-source verification by contacting educational institutions, licensing boards, and certification bodies to confirm the authenticity of credentials and qualifications. Work history and reference checks are also performed to assess experience and reputation, with attention to any employment gaps.
Background and Peer Reviews:
Background checks may include reviewing malpractice claims, disciplinary actions, and criminal records. Some insurers require peer reviews, where other dental professionals assess the applicant’s competence and professionalism.
Application Review and Vetting:
The insurance company thoroughly reviews the application and all supporting documents. This vetting process ensures that the dentist meets all requirements for network participation.
Approval, Enrollment, and Contracting:
Upon successful verification, the dentist is approved and enrolled as an in-network provider. The practice receives a contract outlining fee schedules, billing procedures, and compliance obligations. Careful review of the contract is essential before signing.
Timeline:
Credentialing typically takes between 60 and 180 days (2 to 6 months). This timeline depends on the insurer, completeness of documentation, and administrative backlogs.
Why choose Five Lakes for your credentialing?
Five Lakes Dental Practice Solutions is one of the most comprehensive carrier analyses on the market. Our team has the knowledge and expertise to help determine the very best plans based on YOUR practice and YOUR goals.
We will do all the heavy lifting. And do it right!
- Boost Revenue: Coupled with our Revenue Cycle Consulting and PPO negotiations, Five Lakes will implement your payor contracting strategy to optimize patient access and reimbursements.
- Save Time: We handle over 5,000 credentialing applications annually, freeing your team to focus on patient satisfaction and practice efficiency.
- Protect Patient Relationships: Proper credentialing ensures seamless insurance claims and prevents billing issues that frustrate patients and harm your reputation.
- Avoid Costly Mistakes: We manage PPO plan participation so you don’t lose revenue to errors.
Common causes of delays include incomplete paperwork, slow background checks, or insurance company backlogs. Missing information can significantly extend the process. Five Lakes will submit your applications, track the status, and handle any issues during the process.
Frequently Asked Questions About Dental PPO Credentialing
How long does PPO credentialing take with Five Lakes?
Typically 60-90 days. Doing it yourself often takes 120-180 days.
Which PPO networks do you work with?
All major national payers (Delta Dental, Cigna, MetLife, Guardian, United Healthcare) plus regional plans.
Do you handle CAQH?
Yes. We set up and manage your CAQH profile as part of our service.
Can you credential a DSO with multiple locations?
Absolutely. We specialize in multi-location and DSO credentialing.
What does your service cost?
We offer custom pricing based on your needs. Most clients see a return on investment within the first 60 days.
Ready to Simplify Your Dental PPO Credentialing?
Get a PPO network analysis for your practice. Contact Five Lakes for dental insurance credentialing at (440) 636-1378.
Our team will identify the right networks for your dental practice, optimize fee schedules, and save your team time. Don’t let credentialing errors cost you patients or profits.
Related Services:
PPO Contracting Strategies – Negotiate better fees after credentialing
Marketplace Analysis – Which PPO plans to join