Insurance Success for Startup and Acquisition Dental Practices
Thursday, January 28, 2027
2:00 – 4:00 pm
Course Code:
486TL
Credits:
2
CE Hours
In this course, participants will learn how insurance credentialing, billing, and network participation influence the success of startup and acquisition dental practices. The course will review the steps required to establish the proper legal and administrative foundation before beginning credentialing, including business formation, tax identification, NPI registration, and essential documentation. Attendees will explore credentialing timelines, direct versus umbrella network participation, and common billing challenges encountered during ownership transitions, including temporary out-of-network billing. The program will also discuss best practices for configuring practice management software, ADA claim form settings, clearinghouse enrollment, and payer acceptance to help reduce claim rejections after credentialing. The program will also discuss best practices for verifying contracted fee schedules, monitoring payer participation, confirming that insurance payments are made according to negotiated reimbursement rates, monitoring payer participation, and maintaining accurate provider records after credentialing is complete. Drawing from practical industry experience, the course will highlight common administrative and compliance challenges while presenting strategies to reduce delays, minimize billing errors, and support long-term practice growth.
Speakers
After this course attendees will be able to:
- Describes the legal, administrative, and documentation requirements necessary to prepare startup and acquisition practices for insurance credentialing
- Compares direct payer credentialing and umbrella network participation, including enrollment processes, implementation timelines, and operational considerations
- Differentiate compliant billing approaches during ownership transitions, including temporary out-of-network billing and considerations associated with changes in practice ownership
- Evaluate explanation of benefits (EOBs), contracted fee schedules, and payer participation records to identify reimbursement discrepancies and enrollment issues
- Implement processes for maintaining provider enrollment, managing network participation, and monitoring credentialing records to support ongoing compliance and operational efficiency
- Develop a long-term insurance participation strategy that supports practice expansion, additional providers, multiple locations, and evolving payer relationships
The BEANbite LLC grant has been applied to this course.
The Massachusetts Dental Society is an ADA CERP Recognized Provider
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at
ADA.org/CERP