Dental plans conduct credentialing, which is the collection and verification of an applicant’s professional qualifications such as relevant training, licensure, certification and/or registration to practice in a health care field and academic background, as well as an assessment of whether the practitioner meets certain criteria relating to professional competence and conduct. Licensed health care service plans are required to monitor the qualifications of their participating providers and follow National Committee on Quality Assurance (NCQA) standards.
If you would like to use the Self-Query service, visit the National Practitioner Data Bank website.
If you should receive a request for information related to credentialing, do not panic. Credentialing or recredentialing is a standard process within a licensed dental plan. The intention of the credentialing process is to ensure that enrollees who select a participating dentist can be confident that the dentist has met minimum, uniform requirements. Additional information may be obtained by contacting the professional relations departments at a designated dental plan.