Credentialing

Credentialing is the process by which an insurance company reviews a dentist’s qualifications, licenses, and professional history before allowing them to participate as an in-network provider. This ensures that the dentist meets the insurer’s standards for education, experience, and quality of care.

Once credentialed, the dentist can accept patients with that insurance and bill at contracted fee rates. The process typically involves submitting documentation, verifying credentials, and agreeing to follow the insurance company’s policies and guidelines.

For patients, seeing a credentialed, in-network dentist means access to lower, negotiated fees and full use of their insurance benefits. Dentists must regularly renew their credentials to maintain their in-network status with insurance providers.