What is Credentialing?
Purchasers of health care benefits today are increasingly looking for value — quality care delivered through a cost-effective delivery system. Purchasers helped develop this concept in medicine and are now turning to dentistry for the same expectations. Rather than reinventing the wheel, dentistry is drawing upon the knowledge and experience of organizations such as the National Committee for Quality Assurance (NCQA). This committee is recognized as an authority by purchasers, and is comprised of representatives of employers, consumer and labor groups, health plans, quality experts, regulators and representatives from organized medicine. Most major managed care programs recognize and subscribe to the goals and criteria of the NCQA. Likewise, Delta Dental of Massachusetts had modeled its credentialing program on NCQA criteria.
Credentialing involves a screening of dentists applying for participation and a regular evaluation of those already a part of our networks. We conduct basic credentialing for our DeltaPremier network and recredential these dentists every four years. For our more restrictive networks, dentists enrolling in our DeltaPreferred Option and DeltaCare networks are required to complete the credentialing process as well as an office site visit as part of their application. Delta Dental of Massachusetts will coordinate this information for dentists who belong to multiple Delta Dental managed care networks. Click here to see the frequently asked questions regarding credentialing.
If you have any questions regarding the credentialing process, please call our Professional Relations department at 1-800-451-1249 x1160. Any credentialing information we receive from you is strictly confidential.
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