A common issue that our Virtual Dental Office team is finding when following up on outstanding claims is that the practice believes they are credentialed, but the insurance company says they are not. As you can imagine, this creates an unfortunate situation for practices when they have to explain to the patient that the services were not covered to the degree that was presented to them, or not covered at all. Thankfully we typically have been able to resolve these issues within a few phone calls, however backdating the provider participation starting date varies per situation.
The key to preventing this from happening to your practice is consistent follow up with the insurance company representative. Your practice should be contacting the insurance company every 2-4 weeks once the credentialing process starts. Also I recommend that you request an email that states the start date for credentialing for your practice.