Getting credentialed with dental insurance isn’t anyone’s favorite part of running a dental practice, but it’s a must if you want to treat insured patients and make sure you get paid for your work.
Dental insurance credentialing is basically the paperwork marathon where you prove to insurance companies that your degrees, licenses, and history all check out, so they’ll recognize you as an in-network provider and process your claims smoothly.
Doing this the right way is crucial—not just to avoid annoying claim denials and payment delays, but to keep your schedule full, your revenue steady, and your patients happy.
If it’s not handled properly, credentialing mistakes can hit your bottom line, waste team time, and create headaches you don’t need.
In this article, you’ll find real world pitfalls many dental offices run into when credentialing with insurance and proven, practical ways to dodge every one of them, so you can spend less time on forms and more time with patients.
Submitting Incomplete Applications
Submitting incomplete credentialing applications is a major headache and a top reason for delays in dental offices. According to a 2021 MGMA poll, over 50% of medical practices experienced an increase in credentialing-related denials that year, mainly due to errors like missing license numbers, dates, or signatures.
Even small oversights like blank fields or an outdated CAQH profile can cause the entire application to be rejected or stalled for weeks. The American Dental Association (ADA) indicates that nearly 1 in 5 dental insurance claims are initially denied. These denials result in lost revenue and wasted staff time fixing mistakes. Most common missing items include malpractice insurance details, incomplete CVs, or failure to update crucial profiles such as CAQH attestations.
How to avoid it?
Create a detailed checklist of all required documents: licenses, certificates, insurance policies, and signatures. Have a designated person or a trusted service, like a credentialing specialist, double-check every piece of information before submission.
Maintain digital folders for each provider, and review every application line by line, since correcting missing info after submission always takes longer and costs more than getting it right the first time.
Using Expired or Out-of-date Credentials
Using expired or outdated credentials—even just one—can immediately shut down your ability to get paid for insured dental work. Credentials in this case include your dental license, specialty board certifications, continuing education (CE) certificates, and malpractice insurance policies—anything that a payer or state board wants current proof of before approving or maintaining your in-network status.
Why is this such a big deal?
Suppose even one document on file has expired. In that case, insurance companies will deactivate you as a provider, leading to claim denials and lost revenue, sometimes for months while you scramble to update and resubmit everything.
It can also get you removed from dental networks or, in worst cases, open your practice to legal issues if you’re caught working with an expired license or lapsed insurance. Reinstating your credentials isn’t quick, so these gaps in coverage can really hurt.
How to avoid it?
To avoid all that stress, use a digital renewal calendar and assign a trusted team member (or your credentialing service) to monitor expiry dates for every provider in your practice. Set reminders 90 or even 120 days out for each critical document—licenses, certificates, insurance policies—so you’ve got time to update them and keep things on track without drama.
When your credentials expire—whether that’s your license, board certification, CE certificates, or malpractice insurance—it spells trouble fast for your dental office. Insurance companies will deactivate your profile, deny your claims, and you’ll be stuck waiting to get paid or re-credentialed, sometimes for months. Practicing with an expired license or lapsed insurance can even bring legal headaches and fines, and might get you dropped from insurance networks altogether.
Not Negotiating Fee Schedules Upfront
Many dentists just accept the fee schedules insurance companies hand them without a second thought, but that can hurt your income in the long run. These standard rates don’t always cover the real cost of running a practice, especially if you’re seeing high volumes or offering specialized treatments.
Why does this matter?
Even a small difference in fee schedules can add up to thousands of dollars in lost revenue each year. Accepting low rates without negotiation means you’re leaving money on the table that could be better invested in your team, equipment, or practice growth.
So, how do you avoid this?
Start by researching local fee standards and get a clear picture of what other dentists in your area are charging. Know which procedure codes bring in the most revenue for your practice and focus negotiations there. Don’t be shy about discussing your numbers with insurance reps—sometimes they’re willing to increase rates if you present a strong case.
If the negotiation feels overwhelming, consider bringing in experts who specialize in dental PPO fee schedule negotiation to help you get the best deal. Negotiating upfront puts you in control of your income and can make a big difference in your practice’s financial health over time.
Applying to Too Many Payers at Once
Signing up with too many insurance companies without prioritizing can lock you into contracts with low fees or less popular payers. Many providers carry 16-20 payer contracts on average, which makes managing them complex and expensive.
First, it overwhelms your staff. Handling multiple applications means double or triple the paperwork, follow-up calls, and document tracking. When the team’s overloaded, mistakes sneak in—like missing documents or wrong info—that slow down approvals and lead to claim denials down the road.
Second, signing up with too many insurance companies without prioritizing can lock you into contracts with low fees or less popular payers. You might end up accepting less favorable rates or being inundated with patients from plans that don’t actually bring good business.
How to avoid it?
To avoid this, focus on the key insurance carriers your patients actually use. Look at your patient demographics and pick the top 4 or 5 payers that cover most of them. Start there, get credentialed properly with those payers, then gradually expand.
Prioritizing helps you keep your credentialing on track, offers better negotiating power, and avoids overwhelming your billing and admin teams.
Not Starting Credentialing Early Enough
How long does credentialing take? Everyone has this question. Credentialing can take anywhere from 60 to 180 days, sometimes even longer, depending on the insurance company and the provider’s paperwork.
If you wait too long to start, you’ll end up with gaps where you can’t see insured patients or bill insurance, which means lost revenue and upset patients.Some new providers think they can bill under someone else’s credentials temporarily, but that’s rarely allowed and can cause serious issues.
How to avoid it?
To avoid this, start credentialing as soon as you hire a new dentist or open a new location. The earlier you start, the sooner you can see patients covered by insurance and keep your practice running smoothly from day one.
Failing to Follow Up and Track Status
If you don’t keep an eye on your credentialing applications, things can get lost or stuck in limbo. Paperwork might go missing, or your application could stall without updates from the insurance company. This means delays that hold up approval and keep you from seeing insured patients or billing properly.
How to avoid it?
Clear communication with payers and your credentialing team is essential to keep things moving. Don’t just submit and forget. Use tracking tools and software that let you monitor the status in real time, send automatic reminders for deadlines, and flag missing info before it causes delays.
Set regular check-ins with payers to confirm your application is moving forward, and assign someone on your staff to follow up consistently. These simple habits help prevent credentialing hold-ups and keep your practice operating smoothly.
Poor Data Entry or Incorrect Provider Information
A simple typo or wrong information can cause big problems during credentialing. Examples include using the wrong NPI number, misspelling the provider’s name, entering an incorrect address, or selecting the wrong taxonomy code. These kinds of mistakes often lead to claim denials, application rejections, and a lot of extra work to fix errors.
When this happens, you might face delays getting approved by insurance companies or have claims sent back repeatedly, which slows down payments and disrupts your cash flow. In some cases, incorrect provider info can even lead to accusations of fraud if claims are submitted under the wrong credentials.
How to avoid it?
To avoid these issues, always proofread every detail carefully before submitting applications or claims. Cross-check provider data with licensing boards or official registries regularly, and use credentialing software that can flag common errors automatically. Taking these steps helps keep your credentialing clean and your payments on track.
How Credentialing Support Makes a Difference?
Handling dental credentialing on your own can be a real headache—lots of paperwork, constant follow-ups, and keeping up with changing regulations. That’s why many dental practices turn to third-party credentialing services. Our experts know the process inside and out and can manage everything efficiently, saving you time and reducing errors.
Using a third-party service speeds up credentialing approvals because we keep everything organized, fill out paperwork correctly, and follow up promptly with insurance companies. On average, credentialing takes 60 to 180 days without everything in order; we help shorten that duration. This means your providers get into insurance networks faster, patients start getting care sooner, and your practice can maintain steady cash flow.
Beyond the faster turnaround, our services reduce costly mistakes—mistakes that delay or deny applications. Did you know nearly 85% of credentialing applications are delayed or denied due to simple errors such as missing or outdated information?
Our ongoing monitoring helps keep licenses and certifications up to date, preventing gaps in coverage that could disrupt your billing or risk compliance issues. In short, outsourcing your credentialing means less stress, better accuracy, faster insurance participation, and more time to focus on running your practice and caring for patients.