ADA launches new centralized credentialing database

June 15, 2016

The new database is designed to save dentists time and money when dealing with insurance companies.

You’re a dentist with a stellar set of credentials and you know you can perform any task entrusted to you; with your skills you can really generate a positive impact on people’s health. You obviously want to dedicate as much time as you can to your patients, but your time is often eaten up by trivial administrative tasks. So what are you supposed to do?

In today’s world, dentists are constantly bogged down by repetitive, non-profitable work. Currently when a payer requests a dentist’s credentials, the dentist must respond individually to each payer. However, the American Dental Association is planning to address this overbearing concern by presenting dental professionals with a centralized dental provider-credentialing site.

This new service gives dentists the ability to enter their credentials into a web portal on the ADA website, resulting in those same credentials being available to all payers. Dentists won’t have to repeatedly re-enter their credentials into a system every time someone asks for their information; with this new centralized database, they only have to do it once. According to the American Dental Association, this solution will save dentists time and money in working with insurance companies, which in turn will relieve them of those repetitive tasks they constantly have to deal with today.

Trending article: Updated information on the Affordable Care Act and what it means for your dental practice

This time-saving, centralized database is made possible by the minds of Wonderbox Technologies. The purpose of Wonderbox is simple: “To help healthcare payers remain at the forefront of benefit management through one of the world’s most innovative technology platforms.” Admirably, Wonderbox has done just that. By lending their talents to the ADA, the people at Wonderbox were able to assist in the creation of the new credentials site. Wonderbox will be building and managing the site as well. Craig Kasten, the founder and chairman of Wonderbox, was one of the main contributors. Kasten oversees several other companies including Scion Dental. Scion Dental has a clear vision, which is “to bring next-generation claims management and technology solutions together to enable government entities and commercial payers to improve process efficiencies, achieve compliance and dramatically reduce the cost of delivering dental benefits.” Wonderbox is utilizing the expertise of Scion Dental to ensure they are satisfying the needs of all dental providers.

When the information is properly submitted to the ADA’s Credentialing database, the payers will be taken to their own web portal, through the ADA’s website, to obtain the previously mentioned information. A practice management consultant in the dental industry said they liked the idea of a centralized portal, but also pointed out that it is similar to a W-9 form wherein once you’ve sent in, you’re done.

 

Continue to page two for more on the database...

 

Teresa Duncan, insurance editor for Dental Products Report, supports this centralized database, telling us, “becoming credentialed and then keeping track of the paperwork is one of the biggest hassles of network participation. If a service can centralize and streamline the process, then it will be a hit. Doctors and managers spend an inordinate amount of time on credentialing-any relief in this area would be welcome.”

Other conversations with dental professionals led the ADA to determine that responding to multiple requests for the same credentialing information from different payers is time consuming, and widely cost ineffective. This takes away from time that could be applied to the care of a patient. This new credentialing database provides an answer to this issue in a rather efficient way for the dentists as well as the insurance companies.

Dentists’ credentials will be available to all payers simultaneously through this site. Additionally, dentists will be able to store all of their specific information in one secured spot, and will be able to retrieve that information whenever it would be necessary, as well as being able to manage and update the credentials with the passing of time. Dentists will receive automated reminders from the ADA’s database informing them when licenses or insurance policies are going to expire, as well as just for an attestation of the information to ensure that it is kept to its most current form.

Trending article: 5 ways to tell if dental benefit plans are failing your practice and your patients

The web portal will be free to all dentists, even those who are not members of the ADA (although, non-members will be required to pay the additional cost for the verification service). If you are a member of the American Dental Association, some of the information will already pre-populate into the database, thus saving you even more time.

When asked, how she saw this new database changing in the years to come, Kathy O’Loughlin, executive director of the ADA, says, “Our plan is to continue introducing more automation as we go along to make the process simpler. Right now, if information is missing or needs to be updated, dentists will automatically receive an email letting them know so they can keep their file current.”  O’Loughlin adds, “We are actively working with members and non-members, as well as office managers to understand the additional features and functions they would like to see to make it easier for them to enter and maintain their credentials and work with insurance companies.”

The database will also be launching a portal for the insurance companies to use. This will allow them to download the credentialing information. The ADA will be providing additional automation and services that will make gathering and verifying the credentials less stress inducing. This portal is being regarding as a complete credentialing solution for the entire dental industry.