Credentialing Crash Course, A Dentist's Complete Guide to Successful Credentialing

Welcome to Dental Unscripted, where Mike Dinsio and Paula Quinn break down the practice ownership journey, one episode at a time. Starting up, buying, and running a successful dental practice.

All right. All right. Here we go. Dental Unscripted episode two. We are streaming live. I've got two amazing folks on the horn today. My co-host Paula Quinn. Say hi, Paula. Hi. Stefani Sandoval, our front office coach and guru of all things front office, credentialing, billing, you name it. Today's episode is going to be super exciting because we are talking about a very I don't know, controversial and sometimes challenging topic of credentialing and dental acquisitions.

And it's something that we just run across as a team all the time. And we're gonna just talk about it and break down issues, common mistakes, pitfalls, things that you guys may consider. But before we get into the content, I just want to make some announcements that if you're listening to this or watching this on Startup Unscripted or Dental Acquisition Unscripted, those are two separate channels. Depending on which one you're on, I want to remind you to go to Dental Unscripted right now.

Go to your app, Go to Dental Unscripted. It's the new channel. It's a navy blue and turquoise logo. And all of our episodes are going to be on this now. So at some point, we're going to shut down those two other programs and only be on this one. So all things Dental Unscripted. And Paula now is a full-timer now. She is podcasting. You're a podcaster, Paula. Do you like it? And it's not turquoise. It's Tiffany blue. Oh, Tiffany blue. Is that why you're wearing that today?

It looks very, this is more turquoise or green. Oh, maybe that's where I was getting it. I don't know. I, uh, you know, girls and colors, it's just your best, your best not to even say a color, but okay. I hear you. Tiffany blue, Tiffany blue, uh, dental unscripted is the channel subscribe it so that you guys don't miss any episodes. All right. So let's get into it guys.

Uh, ladies. Um, I'm super excited because you guys are both on, of course, on the next level team and. I'm excited because this new program is all about showing off all of the coaches and we get the chance to talk to Stefani. So let's get into credentialing. So we do a lot of transitions and we're fortunate enough to do the credentialing for those clients.

And it's just always something it's just always something and so I thought you know uh paula from your from your perspective why don't I just pass it over to you like what are the things that you're thinking about that these doctors go through I mean you went through it um with the whole credentialing process it's a very painful process like what um why are we having an episode on it today because it's it's a hot topic Well, I think it just starts with, you know, well, there's lots of things.

I think it's, first of all, just starting, like, when do you do it, right? If you're acquiring a practice, there's a very short amount of time that you can actually flip that. So, you know, I would say, you know, a couple of things they're not thinking about is they're thinking, well, I'm already credentialed elsewhere. Like, what's the big deal? You know, it should be easy. Just... slap my name with a new address on it and I'm credentialed and there's a lot more. I wish it was that easy.

We can dive in, but I think some of the stuff is, you know, having all your stuff prepared, you know, getting it all together so that when that time crunch happens, it can easily transition. I think it's having updated DEAs and malpractice and license. We get handed a lot of things and they're in the middle of expiring or expired or they have malpractice through as an associate. It all just looks completely different as an owner. Sometimes they're not even aware that they're not credentialed.

They think that just because they're working that they're credentialed you know directly and a lot of times it's the you know the associate job they're at the the owner is the one credentialed everyone does it a little bit different um you know, and it's, it's having patients. Once that happens, there's, it gets pretty messy because of the billing and who's not like dental patients, not dental patients, but patients, patients, patients. I'm from Indiana.

It probably comes out all the same word patients because it is a long process. And there is a point where they don't understand that it's also not in our credentialers hands anymore. It's in the actual insurance company's hands. And it sounds like an excuse, but they do what they want to do. They go on vacation. They've got more vacation than the government days. You know, it gets, it gets thrown on someone's desk and Mary points at Susie and Jane and, you know, all the above.

So it is, don't get me wrong.

Sometimes it goes like smooth as butter and then other times it just doesn't. And, you know, our process stays the same. So patience is what they need to have. And I think that if anyone has ever even tried to call an insurance company and they kind of get a little bit of what it's actually like to deal with them. So that's kind of all of it, but I think we should dive into a little bit of each one of those. So, I mean, I would start with what can they prepare?

Yeah. What kind of things they should get together before they're even thinking? Because let's roll this back, Stefani. We'll go to you on some of the technicalities on the things, the checklist that a credentialer might need. But let's put this in perspective. So you're an acquisition. You're going through the process. You just did the... all of the negotiations, you're at the final leg of the purchase and sale agreement. You're stressed out.

You're thinking about all the things of owning a practice and the loan and the conditions of the loan. I mean, it's just a mess, right? Your head's in the weeds. And then and then someone like us says, well, if you don't get credentialing going, all your patients are going to be out of network and then you just have a panic attack. Right. So so so it's like really getting the process started early. And what all should you be like thinking about gathering so that you're totally organized?

I'm going to pass that to you. want to say one thing though too stefani if you can bring this because I don't know if this is a hundred percent true but I would think if they could even understand who they're actually already networked with would that, and could that help in the process?

Like I'm an associate, I'm directed with Blue Cross Blue Shield and Anthem, or I'm with this leasing network, because I know that sometimes we come across like, can we just do a tax ID update and a location change, blah, blah, blah, blah. So what all would you say, you know, their CAQH isn't up to date, they, you know, so kind of think about that with, you know, as you're talking, sorry. No, it's fine. You're completely right. So it's two parts is how am I as the buyer currently credentialed?

And the second part is how is that office currently credentialed? Right. Because you don't want to just go in naive thinking, OK, well, I like the way I am at this zip code in this location and now I'm on the other side.

side of the state and it you know fee reimbursements look different um and you're just caught with the shock that wow okay I thought I was just going to mirror but it may not one be beneficial and two it's not mirroring the office so when we meet you know these acquisitions we try to tell you guys get organized find out the seller's participation right because if we can fast track it so we can get that turnaround time we're just going to mirror it right as long as you do your duty

diligence and get us all your forms you know we're going to set it up to get it done as quick as possible but with these acquisitions because you know these are maybe a first-time buyer right they want to do everything the right way they want to see all of their options so yeah I guess I got it I got a question you know what they want I got a question for you we have people who say we want a mirror and get this done as soon as possible but can you negotiate Yeah.

Well, let's actually pause on that. That's a great topic later on. Like, can you negotiate? And what's that look like? And what's that process? And how's that delay the process? Let's pause on that.

You said something that's really interesting that I was thinking as a buyer's rep, and that is like... knowing what you're credentialed with with your associate positions that's that's solid work with like give some tips on that like what kind of questions to ask the front office gal you work for someone you're not really sure how it all works they did all the paperwork you don't freaking know. So like, what are some of those questions? And think about that.

But like pivoting to knowing what the seller, how they're participating, the challenge on that. And this is you guys even bust my butt on the buyer rep side of like, why don't you guys know this? Well, first of all, broker definitely doesn't know it. They don't know anything. The broker doesn't they don't get into the weeds there. Number one. Number two, the seller usually definitely doesn't know it because she lets Nancy Joe at the front deal with all that.

And the seller doesn't want to tell Nancy Joe that he's getting ready to sell the practice. And so like that's a strange situation. So sometimes not knowing what the you know, if you can, you got a great relationship with the seller and it's all perfect. That is best case. Right. Knowing what the sellers, how the sellers participating. Well, why can't you just say, hey, I'm working with a credentialing company. I want to look at renegotiation and the way I'm credentialed in this practice.

Nancy Jo, how are we credentialed? Yeah, yeah. No, that is- They also have, by the way, they also have fee schedules. They should have only the fee schedules they're using in the computer. Right. Well, we all know that that's not, we all know that that doesn't happen. So- I what guys, you know, you know better than me and we coach a lot of offices with twenty percent actually know what the hell they're doing up front. Like, come on, let's be honest. But maybe that's a little aggressive.

I don't know. But I wish they were that organized. I don't know, Stefani, you were front office person for a hundred years. Like, what are these people thinking and how to approach all this information? Well, I mean, there should always be a paper trail, right? These are contracts that these providers are supposedly signing, right? Nobody should be signing contracts for you to participate. You should, right?

So the best thing I would ask any dentist leaving a practice to go start, you know, their own, whether it's acquisition or even a startup is, gather your contracts before leaving your current employer. I'd like a copy of those contracts because that's also going to help us, you know, the credentialing sign, getting that information of how are you, what are you currently contracting?

Because, you know, you could be contracted at location A and it may block how you're going to participate at location B, right? Is there an easier way though to find it? Yeah. Is there an easier way? Yeah, just asking. I mean, calling. Well, yeah, because what I'm saying is, like Michael said, like this doctor is leaving a practice. He doesn't want to alert his associate job besides, yeah, D-IV students. When you go out in the real world, get your insurance contracts and keep them.

But let's say that I've been working two years as an associate. Now I'm about to buy my own practice without going up to Nancy Jo and saying, am I contracted? What is another way or is there another way that these docs can figure that out? Yeah, they can reach out to the insurance networks independently, right? Hey, here's my name. Here's my locations. Do I have an active contract? It is. I mean, it is what it is.

But insurance companies are also getting to a point where they are trying to stop the multiple contracts at different locations, right? They're trying to really condense it saying, okay, well, if you're leaving here, we're terming this location and adding this location. So you don't have, you know, a whole bunch of different contracts out.

really like insurance companies are trying to do that when on average and this is a statistic that I've pulled through from years and years ago that's ridiculous of them because so many of our clients probably listening or not clients just dentists they work two jobs most dentists actually moonlight for two different practices that's a very very common thing so how ridiculous if the insurance companies just try to do that Well, I mean, they're going to block you, but it's not that to say

that your contract, you can't have two locations, right? Under one contract. The point is, is that they are doing their credentialing. So many times they're asking us to term the seller, right? And we're not credentialing anything to do with the seller.

We don't want to touch that, but they will not allow another contract to go in there under a different tax ID. Yeah. Well, let's get into like that's perfect. I think that's a really good that's a really good thing. So let's go through some of like the big things. So when you're when we're processing Paul and Stefani, you guys can you can take this together because I know, Paula, you touch this stuff, too.

What are some of the most common things that are a problem right before you guys submit the applications? It's like, oh shit, the malpractice has expired. I hear that one a lot. Are there a bunch of things or common things that you see that like, oh gosh, we could have did that a month ago while we were... Can you guys think about some of those things now so that these folks can look into this stuff? I'll let you start, Stefania.

Definitely think one is... OK, yeah, so I definitely think one of them is this malpractice. These dentists who are an associate, they don't necessarily cover themselves with the coverage. It's covered by an employer. So when they're opening or they're buying this new practice, they have to carry their own coverage. So during the credentialing process, we get started and we're using their malpractice that is not theirs, right?

And so we're waiting now to submit time for them to gain coverage, right? Because they don't want to pay for it unless that sale goes through. And so one, that's a delay. And two, that bill of sale, you know, insurance companies don't want to finalize these contracts and these acquisitions without that bill of sale. Yep. Paula, you want to add to that? So I heard malpractice. I heard bill of sale. Well, I think it's their dental license in general.

I think having their CAQH up to date, log on there and pay attention to that and If you're moving states, if you're just having that up to date, I won't get into details, but through Next Level, we've partnered with a phone system where... we can get the phone number in advance and they don't have to pay in advance um you know there's there are certain things that they can do um you know I I just think as soon as they're looking if they can even meet with someone like us

just to get that checklist of things they can start getting in order and then just be be diligent about it you know we have docs that are in such a hurry to credential, we give them the list and it takes three, four weeks to get that crap in. And yes, we might still be waiting on the bill of sell, but sometimes we can get those applications even filled out if they're not online. And we can have them ready and waiting.

So there are just, you know, there's only so much we can do, but we can get prepared as much as possible. When we're sitting waiting on a updated malpractice or for them to hunt down, you know, something, you know, it just doesn't need, we just need that bill of sale at the close and we're ready to go.

Yeah. yeah I I find it's uh it's funny because like I'm not a clinical person right at all you guys always make fun of me I'm the business guy of the group and definitely don't well michael yeah Uh, you guys could, I'm sure hear the, the, um, uh, sarcasm there, but, uh, yeah, I, I am definitely that, that one in the group and, and, you know, like these documents like CAQH and the, the, it's like a Chinese code sometimes I I'm getting pretty good at it now, but.

I'm sure you guys feel the same way as providers. I mean, some of this stuff might be a little bit more familiar to you for sure, but I get what's a CAQH or how do I do the MPI too? And all these things, right? And so I think before we pivot to the next topic, which is timeline,

I'm going to timeline next lady. So that's going to put you on the hot seat a little bit. But before we go to that, like just, I think Paul is right on point with, You got to work with a professional, whether it's next level or someone else. And you got to start the process early and you got to have that conversation of what are the things this company is going to need from you so that when the time comes and you're submitting apps, you can go because that does parlay into timeline now.

So that is the next question is if you guys get really dialed in on checklists and all the things, What's the timeline? And there's a lot of crap out there. A lot of people say, oh, you can get it done in a month or two months. Two weeks. Yeah, two weeks. It only takes two weeks for Delta. Yeah. I love that. And then you hear other people, other credentialing companies say it takes freaking a year. And so... I think we should talk about this. What is the timeline? What should be the expectation?

Yeah. You don't have to raise your hand. I just want to say there's a difference between I'm coming in an office as an associate. Mary up front needs to add me as an associate. Yeah. Then owning your own business is, becoming the business owner and now having to have your own tax ID, your own MPI to your own credentialing. Now, if you own for five years and want to bring in an associate, we might be able to get Delta in two weeks.

Yeah. Yeah. And it depends on the state, but there's a difference between buying a business and and creating a completely different entity than there is, I'm now working for Dr. X and he's gonna put me under, he or she's gonna put me under their tax ID. I just wanna state that because we hear it all the time from front offices say, oh, well, I got that associate in two weeks. First of all, I would be shocked if it was exactly two weeks. However, huge difference.

Okay, I'm going to let Stefani take it. No, I think that's good. Stefani, can you touch on that? The difference between MPI-I and MPI-II and why the insurance companies are doing it this way? I think that's important for the audience to understand. Right. Well, in any type of credentialing, right, there's credentialing and contracting. And so we have to get a contract not only established for the provider, but for the entity itself. So it's kind of like double whammy.

Right. So Paul is one hundred percent right. It's not that quick as much as we would, you know, and to throw into that as well, that then we have to talk about terminating. Right.

the current seller so it's like three contracts that have to be done in order for it to be successful and it does take time um you know insurance companies what are you doing wait on that termination part sometimes don't you have to terminate like let's say dr quinn is now owning and she's with signy here don't you sometimes even have to terminate my own contract because I'm at other locations on the participation yeah sorry yeah no they'll say okay great are you no longer going to practice at

this associate job right so there's so many different little contractings that are contracts that either have to be terminated or established so yeah ideally we would love for it to be so quick but again we're playing a game with this insurance company you know we knock at their door every week, just being annoying, trying to get, you know, it moving along. That's why we're so successful because we're so annoying.

I'm not sure what the key is, but patience is obviously something that has to be established and expectations. If you think you're going to get in there day one and in thirty days out of sight, out of mind, you don't have Any other credentialing issues, you're sadly mistaken. So what are we talking about, ladies? Are we talking about worst case? Sorry, best case, you know, four months, worst case, twelve months. Like, what do we like? Can we put some brackets on it?

Like I if a credentialing company like us is touching it and owning it and following through and all the things. And and look, I always say on the podcast like this is. This is like in theory, this is like theory class textbook, right? We're giving you textbook answers, but like Stefani said, if you're an associate somewhere else and this and that and the MPI too, like it's, it all changes. There's variables to this, right?

But in theory, if the perfect world was happening and everything worked out really great and it was super clean and not complicated bracket from what to what, what are you expecting here? What should you expect post-close after you buy the practice? I would say we're probably around a twelve week turnaround. You know, that's what insurance companies, you know, twelve weeks and business days, you know what I mean?

But to Paula, you know, at the very beginning of the show, she said they are never in office. Right. They're always out. A part of what can delay things is if you're not truthful on these applications, if they're not complete, if they're missing something, because then you're starting all over again. Right. You got to go back into the line. So I do think insurance companies give us a timeframe, whether they stick to it or not is a whole nother conversation we can have.

But you know, these are the guidelines that they give us, but always we're expecting, you know, we have more volume than we can handle, or we are behind this many weeks. So I think it is, I would say a minimum to give yourself is twelve weeks. I mean, we've definitely seen Delta a little bit quicker, but again, it has to go perfect, like really perfect. But we have definitely seen that one good thing is we can not even think and put that application in pretty quickly right when the sell happens.

They don't typically negotiate. So even when a doc wants to look at all the fees and all their options, Delta Swan, we just kind of say you're kind of you get what you get. So let's just fill that out and get going on it. So that's number one. And then we have, you know, we have the whole. Right now, it's Anthem, used to be Cigna. It's taken nine. We've had a year on some of these. The other thing about leasing networks is, and Stefani might have to correct me, once you...

If you're using a leasing network, once you're credentialed with a leasing network or in contract, I don't know the proper words for it. They get up to ninety days to actually notify the actual individual insurance carriers under there. So, you know, I might I might be in with connection, but connection might not notify Humana for an additional ninety days. So guess what? I'm out of I'm having out of network conversations now. with my patients.

So I think that's probably the next place is how to be prepared when you open and you are not in network with insurance companies. Yeah. You're, you're reading, you're reading my mind. I had it queued up here. What's the impact. Nice work, Paula. It's weird. Brain waves here. We have worked together for a while. We have.

And so, so just to put like a, an explanation point on, on those, those two first topics of getting organized and pitfalls folks, if you didn't, if you didn't hear it, I'll just say it. Dummy Denzio style. Get extremely organized and cross every T and dot every I. And get lots of patience. And have lots of patience. That's right. Because...

Like as a buyer rep, before we brought this in house, because we brought it in house a while ago and we process, I don't know, a lot every year, probably close to forty of these a year. And before I'd refer like other companies, said name companies and I mean, what the hell is taking so long? What's their problem? Now I feel those companies pain. I know exactly what.

And my clients, like even now hearing you guys that manage this department, like it's like you guys never can get their their documents and the details are terrible and their malpractice is expired. And I'm just thinking to myself, these are dentists who are very.

very educated guys. If you're listening, you're very educated. You took the test you and sometimes took the boards. You dude, you're doctors. This is the time to dial in and get detailed and cross every T dot every I and get organized because the work that you put in on the front end bears the fruit on the back end.

And, and so that tees us really nice for what's the impact of If you don't get it going and you're not prepared and you close on the business and now all of a sudden these patients you're meeting for the first time and you got to say, oh, we're out of network with you. We're working on it. They hate you right now, right? So not really, but that is the impact, right, ladies? Like the patients and let's have that discussion.

Paula, when you owned, I think you were out of network for a hot minute with some of these. I don't know. What are our clients facing by not taking this extremely seriously? Does that make sense, what I'm asking? Well, before we go there, there was just one more thing we wanted to mention that we forgot on the pitfalls. The other thing is that we run into is offices or dentists need re-credentialed. So they're right. They've been credentialed with their associate job.

And we go submit an application for because there are different applications for different things, too. Just so everyone knows it's not some some insurance companies. It's all one. But others, it's like, are you doing this? Are you doing this? Are you doing this? And sometimes it's. You know, it's different for each one. So we'll submit a particular application based on them now being an owner. And it'll be like, oh, you need to be recredentialed.

So there's a whole nother process for being recredentialed if you've been credentialed before. So I wanted to throw that out there because it is another thing that we we come across as a pitfall. But as for the out of network, it literally is. okay, I'm going to say this because I'm experienced. When someone says, I'm going to say this, you got to like, people are turning up the volume. Yes. It's not that hard. Dental offices make it very difficult when they're out of network.

Um, there's two different things when you're completely going out of network for real, for real. There's one conversation that can be a little bit more, uh, you know, of a process and really need to dial in everything. But when you're only doing it in the interim, and you can still honor the insurance network fees, the allowable amount, that's not a hard conversation. They make it very hard. What do you mean? Why? Why are they making it hard, Paula? Walk us through that.

What you mean is Mary and Nancy Jo, they're making it hard? Sorry for all the Mary's and Nancy Jo's out there. Well, and even the dentist, because they don't know and they hear it and they start flipping out because Mary Jo said something and it's like, calm down. We give them this. It's just that I don't know what happens. Anyway, I would say, first of all, nothing should change. If you have fee schedules in your software and we'll just use Delta as an example. Well, let's not use Delta.

Let's use Guardian as an example. You're nothing's going to change. Your conversation with the patient is not going to change. The way you submit a claim is not going to change. The only thing that's going to change the amount you get back from the insurance company. That's it. And no one really knows that. So it's not a big deal. Don't delete your fee schedules. Don't stop attaching them. Just treat it like you normally do. I would say most doctors go with the exact they mirror.

So your dentist is going to mirror what the seller is going to do. Your process doesn't change. So stop making it complicated. You're going to honor the patient's allowable amount, their copay that you would have before. You're going to submit the insurance claim in your UCR. And yes, the insurance company is going to pay you a little bit more because you're out of network in the interim. It's that simple.

Now you've taught me for the folks that know their stuff, other consultants, other credentialing companies, whatever you've taught me that that does impact, uh, well, I'm, I'm the dumb one here in the room. So, uh, but so we should probably mention that though, you know, where I'm at right now. So let's mention it. Well, it does impact their maximum. So a patient gets a thousand dollar maximum.

It's going to impact it because the insurance company is actually going to reimburse more, which is going to quickly eat that up. But honestly, anybody over a crown and a root canal is going to have to pay out of pocket anyway. They've just they're a maximum benefit anyway. I can't stress it enough. front office people, you do not work for the insurance company. You work for your dentist and the patients. And that's it. They've got to learn that. Stop worrying about, yes, we have to be honest.

We have to tell patients, but you tell them positively. Actually, Stefani's got a great way she talks about assisting. Stefani, go for it. Do your verbal skills on that. No, it's just, you know, Any news is good news when it comes to insurance coverage, right? We have to get out of the mindset of entitlement, right? And think of it that it's great news. They're going to assist you with twenty five percent rather than no percent. And we behind the scenes are like, God, that coverage is terrible.

Right. But any news is good news. Right. And so it's always assistance when people start. Start thinking as an entitlement. Oh, well, this, you know, cleaning is free or, you know, I don't have to pay. It's not you in all of that coverage, you know, and that's an estimate. Let's just make that very clear. But I think to go to what Paula was saying about these front office, I think what's really, really hard is at the moment you try to change something. And now we've got a new dentist.

So they're already, you know, on guard. But then we are and, you know, our estimates are really, really off. We're just losing, you know, the chance to maintain them and really sell this new doctor. So I would really, really recommend, you know, to Paula, keep it the same. Business is normal. What it looks like on the billing side, we'll handle that. Right. Claims come in. We are electing not to charge anything in addition, which we can. Right. But that's that's. the offices part.

Don't let the patients feel that. What I heard was, is don't overcomplicate this. And I think this is a very, very complicated subject. It's really hard to do a podcast on it. So ladies, you're doing a great job trying to explain literally a Chinese menu. And after three years or however long we've been doing credentialing, I finally feel like I got ten percent of what the hell you guys are talking about.

But um the point the point is this is a very complicated situation you've got you got nancy joe telling you one thing post close you got your credentialing company telling you another then you got the law telling you one thing and the insurance company and contracts telling you another thing so you're getting all of this information it's really tough for you all I think at the end of the day, I think Paula said it perfectly.

So rewind and listen to that part is just just chill and keep doing what what you're doing and have the same conversations and and everything's going to be fine. But it is a it is a creepy topic and there's a lot of opinions out there. So with that being said, you'll and then you'll also notice that this conversation is about credentialing. But here we are talking about verbal skills. I think everything comes down to verbal skills, Paula.

I mean, don't you agree on how you deliver how you deliver what a complicated situation or a hard conversation or a treatment plan, a treatment that's gone wrong or a billing thing? It's all about how we communicate. Yeah, and I think that for me, I'm going to state this very simple. Why trust someone who's done it one time in an office for an associate versus a company who's done it hundreds of times?

And not just hundreds of times, hundreds of times for acquisitions, hundreds of times for startups. Like why we're on a forum listening to other dentists who have never credentialed themselves. Right. They've gone through a process. They have no idea what process they've gone through. Oh, I became an associate. I was credentialed in two weeks. Number one, you don't know. You truly don't know. Number two, phone offices work in one, hopefully max five places their whole life.

How many times are they credentialed?

listen to a professional company we have nothing to gain by extending your credentialing time why would why would our team want to track your credentialing for nine months or a year why would we want to do that we want to like there's nothing we want more than for you to be off our plate in three months and not because we don't love you but because we're just getting more and more credentialing the quicker we can track this get it because it's a lot of tracking It's a lot of front leg work.

It's a lot of during work and it's a lot of tracking. Nobody wants to do this. I promise. So trust us when we say we do everything in our power to get you credentialed as fast and as painless as we can. Now it's up to you to understand the process and the timelines and give grace because it is there is a point that it's out of our hands and there's nothing we can do but check on it. We can yell, we can scream, believe me, we have. We can hang up on people. We can threaten, we can threaten.

At the end of the day, you call, and that's the other thing. Let me just state this. When you call majority of insurance companies, so I'm Nancy Jo at the front desk and I call and say, how's our credentialing going? You're speaking to a representative that doesn't even have access to the backend. They don't even because I get it. And I say, there's no way I have proof. Well, then I'll get pushed through, pushed through, pushed through.

Finally, I can get a hold of somebody that actually knows and can give me an answer. But when you call up and say, oh, am I a network? And they say, no, oh, we don't even have an application on file. Like, don't have a heart attack. That is not true. We submit applications. They're submitted to usually an entirely different team than the front end when you call to check on a patient. The outsourced call service company that they've outsourced in India or something.

When the roosters are crowing in the background. Right. You just it's such a process. And again, I'm going to state it. We don't want you any longer than you want to be with us. And it's not you. It's it is one more thing on our credentialers plates. It's it's almost like a joy for us to check the boxes. So if we get to check a box and you graduated from college. you know, here to here to here to, Oh, we're done. I mean, it is the happiest day of our life. So yeah, that's awesome.

And I'm sure that, you know, a lot of companies out that feel that way. But I think that, you know, the other thing I just want everyone to know is as compared to other companies, I want them to know why we're different. And I think why we're different is we are a fairly small team. We're not, We're not a big, big company. And a lot of times we're dealing with our own clients. So these are clients that we're going to have in membership or practice management or billing.

And we want that relationship to be amazing. So we do everything in our power to be boutique and make sure that they're getting white glove. And I know it doesn't feel like it, but I think the reason it doesn't feel like it is because they just don't understand the process. If they could live a day in our shoes, they'd be like, holy crap. These guys care. They're doing everything they can. I love that. Stefani.

no I mean how so it it's easy to get passionate about this topic stefani any last comments from you that that's in the weeds and grinding with these insurance companies every day getting the the emails from the clients of worry and and distress any final comments oh we got a delay on stefani's end um I yeah I think that it's really in oh sorry now you're you're you're you're fine stefani uh if you if you want take it away and any any final comments okay yeah yeah I think you know The same thing,

comparing credentialing to a claim, right? Trying to give the insurance company's networks everything and then some, you know, so they don't have to come back and ask us for anything. But even though credentialing, you know, could be complete, in your case, you are still going to run into issues with the carriers, right?

And it's really important to know what's the difference between a credentialing issue and what's the difference between, you know, insurance processing issue, whether it's they are showing you out of network or they're having you with the, you know, incorrect fees. It's really important to be resourceful during your credentialing. journey, just knowing who you should be going to, what questions you should be asking.

And if somebody's never been in here, they can feel like they're just drowning and they don't know where to go. So I think it's important to really educate the team saying, if this is an issue, here's where we go. If this is happening, this is where we go. That's perfect. I think that's on point, Stefani. Yeah, this is an interesting topic.

We didn't get into kind of like the strategy and how to maximize and how... to get that bigger fees because you can there's too many people saying you can't you absolutely can get better fees and um to paula's point of being a boutique uh organization that's what we pride ourselves on getting getting our buyers uh higher fees than the seller and that's a bump that um that's a free bump congratulations you get more money for doing the exact same procedures and you can do it no not from

delta not from some of the ones that have us um uh have the biggest stick in the in the on the playground no you can't beat them up but there's a lot of other ones you can, and it can give you a serious bump. So maybe we can touch that on a future podcast. We've also done this credentialing episode in the past. And so check that out if anybody's doing that one. But ladies, thanks so much for joining us. And Paul, of course, helping me co-host this new brand of Dental Unscripted.

Mike D'Incio, Paula Quinn, Stefani Sandoval here signing off. Guys, we've got a lot of other episodes coming down the pipe, and I'm really excited about the lineup we have in the next few months. So stay tuned and subscribe and follow us along the way. Cheers. Take care. Thanks for listening. Let us know how you like the show. Rate us on Apple and Spotify. Subscribe and follow for more.