MCNA Dental Credentialing

MCNA is a leading dental benefits management company dedicated to providing high-quality services to Medicaid, Children’s Health Insurance Program (CHIP), and Medicare members through state agencies and managed care organizations. We cordially invite you to join our network of primary and specialized oral health care providers. MCNA is a programme that caters to providers. Our relationships with our providers in each region have been critical to our success.

If you want to enroll in one of the following states, please go to our state enrollment page:

  • Medicaid and CHIP in Arkansas
  • Medicaid in Florida
  • Medicaid in Idaho Smiles
  • Dental Wellness Plan in Iowa
  • Medicaid and CHIP in Louisiana
  • Medicaid in Nebraska
  • Sooner Select Oklahoma
  • Medicaid and CHIP in Texas
  • Medicaid in Utah

Please follow the steps below to join our network in any other state:

  • Online enrollment is available.
  • Completing our Online Credentialing Application, which includes all required forms, is the final step.
  • Enroll via fax, email, or postal mail.
  • Although the Enroll Online option is recommended for the quickest turnaround, you may also download, print, and complete the documents below to begin the contracting and credentialing process.

Download and complete all of the forms listed below (Adobe Reader may be required to view PDF files).

  • Form for New Provider (one per dentist)
  • Form for a New Location (one per physical location)
  • Dental Provider Contract
  • W-9 Form (IRS)
  • Form for Choosing Payment Methods
  • Form for Ownership Disclosure (Florida Providers Only)

What is the purpose of Credentialing

The procedure of obtaining a license to practice medicine as a doctor has multiple functions. To ensure that all physicians are operating to the standard of care and providing the clinical services they are certified to perform, credentialing provides quality assurance to the medical business. This safeguards both the patient’s safety and the medical profession as a whole by guaranteeing that only doctors with the necessary training and expertise are allowed to treat insured patients.

Third-party payers can also be paid on time and properly reimbursed if medical practices are credentialed by their contracted third-party payers. The number of patients who have access to credentialed medical practices can boost their revenue sources. Medical credentialing is essential for a successful medical practice in light of more convenient payment options and larger patient pools.

How to get credentialed?

Credentialing has many advantages, including the following:

  • Acquiring a certificate is a crucial milestone in one’s professional life. It shows that you’re not only knowledgeable, but that you’re also committed to your career advancement. Certification is an option for healthcare professionals:
  • Self-improvement and self-challenge
  • In order to raise wages and broaden career prospects
  • To show patients, doctors, and payers that you have the skills, expertise, and competencies they need.
  • To set oneself apart from their peers by demonstrating a lifelong dedication to education and job advancement.
  • Employers in the healthcare industry value qualified staff for the following reasons:
  • It’s a method of attracting and retaining high-quality healthcare workers.
  • The ability to demonstrate that healthcare professionals have satisfied standard requirements
  • A growing body of research shows a connection between certification and successful outcomes.

Credentialing has numerous advantages.

Patient Confidence in a Provider’s Credentials is increased by Credentialing

In the healthcare system, trust between doctors and patients is essential. As a result of trust, patients are more likely to open up and share information because they believe they will receive better care and have more faith in the therapy they are receiving.

Prevents Medical Mistakes

About 98,000 people in the United States die each year as a result of medical errors. This alarming figure has compelled industry executives to advocate for higher competency standards and increased disciplinary action against healthcare professionals.

Medical malpractice can be minimized by ensuring that healthcare providers, particularly independent practitioners, are properly credentialed. Automated credentialing eliminates the human error and tiredness that are associated with the manual review procedure.

Reduction in Restrictions

More services are now covered by insurance plans thanks to healthcare credentialing, which has reduced restrictions on preexisting conditions. Pre-existing conditions are no longer grounds for denial of insurance coverage, increased premiums, or denial of payment for essential health benefits by any insurer. As a result of this, patients are less likely to seek out the assistance of professionals who are currently unemployed.

 Maintains the Doctor’s Position in the System.

Credentialing plays an important part in the examination of the history and practice of a health professional. Before a professional can join a network, he or she must go through a rigorous screening process. There is more to come, however. Depending on the insurance provider’s policy, the credentials of the expert may be reviewed on a regular basis.

Enhances the business of the practitioner

Physicians can accept patients who have health insurance if they are credentialed. As of right now, the vast majority of Americans are covered by a health insurance plan. Consequently, the practitioner can brag about an increase in clients.

Furthermore, it appears that most patients prefer to see the same doctor over and over again. Physician credentialing, thus, leads to a steady flow of patients, which in turn boosts the practitioner’s bottom line.

The reputation of Health Practitioners is improved as a result

Healthcare practitioners need to maintain and control their online reputations in order to keep their clientele as more and more people are investigating their providers online before making a decision. Medical credentialing is one of the most crucial measures that professionals can take in order to enhance their reputations.

All patients can be treated by a practitioner who has completed this process, regardless of their insurance coverage. Patients from all around the world will trust the practitioner because of the wide range of patients he or she can treat.

Prevents Healthcare Organizations from Being Sued in the First Place

Laws requiring credentials on legal documents such as prescriptions and medical records exist in numerous states. These regulations also apply to professional activities such as speaking engagements, research publications, and legal testimony, among others. The hospital could be breaking the law if it doesn’t have the right credentials.

Healthcare organizations must be credentialed to guarantee that they are adhering to all applicable regulations. In order to access the National Practitioner Data Bank (NPDB) queries, clinics must first register with the National Practitioner Data Bank (NPDB). This permits them to continue their training in a safe and legal manner.

Patients who are unfamiliar with their doctor’s credentials are less inclined to put their whole faith in the doctor. In order for patients to have faith in their selected healthcare providers, it is necessary to verify the qualifications of hospitals and healthcare organizations, such as the American Hospital Association and the Joint Commission.