Established in 1958, the Client serves more than 1.4 million patients with high-quality, cost-effective, evidence-based dental plans. As one of the largest, most experienced dental benefits providers within the coverage area, the Client’s leaders realized the need to implement a solution that solves one of payers’ and providers’ greatest pain points: the credentialing process.
The existing process was extremely manual for both staff and the providers they supported. Upwards of
70 percent of applications were submitted incomplete. Weeks were lost to rework and resubmission of missing documents and information via mail and fax. Application packets with supporting documentation averaged 40 pages. Each page required manual date stamps, initials, and signatures. Approvals consistently took between 45 to 90 days. The process was also confusing for providers and the staff completing the applications. They wanted a unified online platform for their providers to complete and track all credentialing and re-credentialing needs. A platform that did not currently exist within the dental market.
Finding the right partner began with a strong foundation. As an industry leader in dental claims management and payments, DentalXChange saw the need for a streamlined cloud-based credentialing platform. The Client recognized an opportunity to partner with DentalXChange to collectively bring change to the industry and improve the credentialing experience for providers. With the market knowledge and technical infrastructure already in place, DentalXChange was able to quickly implement a co-branded solution in collaboration with the Client to increase efficiencies and save time by automating the credentialing process.
With the dental adoption of electronic transactions lagging the medical industry, there was initial concern that dental providers would be hesitant to adopt a paperless process. Those concerns were quickly dispelled with 99.9% of credentialing and recredentialing packets now being submitted online.
DentalXChange’s CredentialConnect platform helped bring efficiency to the process and accomplish key objectives for the Client. The number of incomplete applications dropped dramatically from 70 percent to zero. The platform’s intuitive question-answer wizard guides providers through the application to help ensure that all required information and supporting documentation is submitted correctly the first time. This reduced the firsthand assistance that the Client needed to provide to complete the applications.
CredentialConnect also helped the Client meet National Committee for Quality Assurance (NCQA) performance standards. The reporting and design of CredentialConnect meets industry best practices for date and signature stamping to fulfill internal audit and contractual partner requirements.
Due to the ease of use, the Client has not had to increase credentialing staff since the implementation of CredentialConnect even while their provider network has grown. The credentialing and recredentialing needs of the more than 3,700 dentists is supported by two full time employees.
For providers, the turnaround time involved with credentialing can be stressful and impact revenue generation. The CredentialConnect platform drastically reduced the application time. New providers completed applications within 30 to 45 minutes. Recredentialing is even faster at seven to 10 minutes.
For the Client, approvals take an average of 7.5 days for initial credentialing. Recredentialing turnaround time has been reduced from 85 days to under 33 business days. Both are far short of the industry average of 60 to 120 days.
According to the Project Coordinator and Credentialing Lead for the Client, one of the biggest stress relievers for providers is the transparency that CredentialConnect provides. Providers can login to check the status of their applications at any point during the process. Results are updated in near real time, so they always know their status, eliminating the need to seek updates through other means. When credentials are nearing expiration, the solution automatically sends recredentialing notifications, so providers know to start the process.
The DentalXChange solution provided unexpected benefits too. As new payer clients came on board and new features were requested, DentalXChange shared enhancements as basic functionality on the platform while still maintaining client-specific customization.
