Pair Dental can credentialing any Specialist we match you and any other dental provider in general.
Commercial: 30-45 days
Delta: up to 6 months
Medicaid: 90-120 days
Managed care Medicaid: 30 days after Medicaid acceptance
HMO: 45-90 days
Delta: up to 6 months
Medicaid: 90-120 days
Managed care Medicaid: 30 days after Medicaid acceptance
HMO: 45-90 days
Your NPI type 1 is issued to you as an individual provider. NPI Type 2 is assigned to a practice or facility. If you don’t own a practice, you probably do not have a NPI type 2. These two numbers are also unique and separate from your tax ID number (or EIN) which is the number the secretary of state assigns legal entities.
It takes about 6 months to obtain contracted specialty fee schedules. You cannot bill out of network. The practice is keeping 100% of the capitation check while the fees have to be upgraded with other codes to supplement. Synergy tends to attract more PPO/Fee for Service types of practices but occasionally there are HMO practices that can arrange a desirable treatment day for the specialist.
Typically specialists go in-network with the same plans the practices have in place. If there is a particular type of plan you are hesitant to go in-network with, please address this with us and the practice owner before credentialing.
Yes you can, as an out of network provider. Some plans have out of network allowables, others do not. If they do, that means less out-of-pocket costs, as the insurance company will pick up some of the cost, and the practice can bill the patient directly for the remaining balance.
State License, Specialty Cert (and/or) Board Cert, Professional Liability, DEA, and more depending on your existing credentials, state of practice, and insurance plans you’re applying for. Head over to our credentialing application for a full list.
Normally every 3 years
