Content Dam De Print Articles Volume 106 Issue 5 Ada Logo

New ADA portal makes credentialing a 'one-and-done' process

June 13, 2016
The American Dental Association (ADA) and Wonderbox Technologies have collaborated to bring dentists a new centralized credentialing database in a securely designed portal on the ADA's website: Dentists only need to enter their credentials one time to make them available to all payers.
The American Dental Association (ADA) and Wonderbox Technologies have collaborated to bring dentists a new centralized credentialing database in a securely designed portal on the ADA's website: Dentists only need to enter their credentials one time to make them available to all payers.

The American Dental Association (ADA) is collaborating with Wonderbox Technologies, part of the Skygen USA family of benefit management companies, on the launch of a new centralized credentialing database that will allow dentists to enter their credentials one time in a securely designed portal on the ADA’s website, and then have those credentials available to all payers. The new portal is expected to save dentists and/or their office managers weeks of work that would otherwise be spent repeatedly filling in the same information on multiple applications.

Apex360 caught up with ADA Executive Director Kathleen O’Loughlin, DMD, MPH, and Craig Kasten, Skygen USA chairperson, to talk about the drivers behind the unusual collaboration and about what the new portal will mean to dental providers.

What was the impetus behind this initiative?

O’Loughlin: The ADA is always looking for new ways to add value for our members. Through conversations with our members, we recognized that credentialing, while very important to ensuring the integrity of dental networks, is a time-consuming, costly administrative task that takes dentists away from patient care. Every hour dentists or their staff members spend filling out a credentialing application is an hour they’re not providing care for patients. It would be bad enough if credentialing was a one-and-done type of operation. But what really challenges our membership is having to fill out the exact same information for each dental provider network they participate in. It’s a lot of unnecessary repetitive work. By creating the credentialing database and dentist portal, which will live on the ADA website, dentists will only have to fill in the information once and then update it periodically. Health payers can then access these files on-demand for a nominal fee.

How did Wonderbox Technologies become involved?

Kasten: Through our sister company Scion Dental, we work closely with dental payers and providers to set up dental networks. We saw the inefficiencies in the process up close and realized there had to be a better way. All of the Skygen USA companies are dedicated to using automation to help providers and payers save time, save costs, and reduce the amount of manual labor it takes to perform repetitive tasks. And nothing is more needlessly repetitive than the current credentialing process. We thought it was time to use technology to bring credentialing into the 21st century by moving it into cyberspace. We had the technology and the expertise, and we approached the ADA about being the engine behind the credentialing database. It was fortuitous timing, as they were looking for a way to solve the same problem. We worked out the details, and here we are.

What made Wonderbox Technologies want to partner with the ADA on this project?

Kasten: We saw a need and knew we had the ability to fulfill it. There are many processes throughout the health-care industry that are stuck in old manual methods or that use old technologies that don’t translate well to our current world, much less the future. We have the technology, expertise, and experience to make a difference, and this credentialing portal was a tremendous opportunity to demonstrate it on a large scale.

It will also be a huge benefit to our payer clients as we help them build their dental networks. In the long run, the time required to contact each dentist individually with an application, follow up with them multiple times to get the application back (only to find that information is missing), and then work to verify and finalize the files slows down the entire process. By building and maintaining the credentialing database, we can make the process far more efficient and cost-effective. Everybody wins—both payers and dentists are relieved of a costly administrative burden.

How will the dental provider portal work?

Kasten: Roughly 99% of the information required by different payers and different states is the same. The core application will include all of that information. The ADA is providing usage of the credentialing database as a free service to all member and nonmember dentists. Additional cost for the verification service will be required of nonmembers. For dentists who are ADA members, some of the fields (such as name, address, and license number) will prepopulate based on information that is already in the ADA membership database, saving even more time.

If information is missing, or if it needs to be updated, those dentists will receive a series of e-mails prompting them to return to the portal to make the updates. The beauty is that once the information is in the database, it only needs to be updated when something changes, such as a license expiration, an office location change, or an attestation update. It truly is one-and-done. And given that it’s free to all dentists whether they are ADA members or not, it’s really a no-brainer to participate.

Who will own the information once it’s in the database?

O’Loughlin: The data will belong to the ADA. Wonderbox Technologies will manage the data warehouse, database, and security on our behalf in the cloud, but the data itself will be ours.

When will the portal become available?

O’Loughlin: We are currently running a pilot program in New Jersey, Nevada, and Kansas to test the functionality of the portal and see how it handles large volumes of users. We want to see how it works and also get reactions from dentists who use it to understand what they like best about it, so we can use that information to serve more providers. We expect to complete the pilot and analyze our findings in time for a national rollout this summer. So far, it seems like there is a pent-up demand for the credentialing database and portal among dentists.

For the most current dental headlines, click here.