Navigating the Contracting and Credentialing Process: What OMSs Need to Know - On Demand Access
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- Member - $265
- Resident Member - $265
- Allied Staff Member - $265
- Professional Staff Nonmember - $265
- Other Nonmember - $265
Deciding whether to become a participating provider for insurance companies is vital to the OMS practice’s patient acquisition strategy. Equally important are validating credentials and selecting the right payer contracts. Additionally, understanding the contracting and credentialing process while avoiding pitfalls reduces administrative frustration. Credentialing is an ongoing process that impacts claims payment, amount paid and profitability, and it must be incorporated into all steps of expansion planning. This 90-minute webinar will focus on recent network participating agreement language and steps for organizing documents for submission in the contracting role. OMS practice owners, administrators and team members will learn how to stay up-to-date with dental insurance industry changes. Important tips for being efficient when credentialing practice doctors will be shared.
Learning Objectives
At the conclusion of this program, participants should be able to:
- Identify factors to consider when deciding on network participation.
- Discuss key words and phrases in contract language that may have an adverse financial impact on the OMS practice.
- Recognize verification vehicles via organizations like the Council for Affordable Quality Healthcare as well as what to consider when outsourcing.
- Examine the steps to successfully credential OMSs to become participating providers with various third-party payers.
An Internet-based CDE/CME Activity
Original Release Date: November 13, 2024
Expiration Date: November 13, 2027
Estimated time to complete this educational activity: 1.5 hours
Method of participation: Self-Study
Patrick J. O'Rourke
Founder/CEO
Practice Quotient, Inc.
Patrick O’Rourke began his career in operations management at a dental & vision insurance company in Florida, which after several acquisitions and mergers, is now MetLife. He spent five years at Humana in Atlanta selling in the large group segment (100+ employees). In addition to several awards throughout his career, he has earned many professional certifications. Understanding the nuances involved with all aspects of risk management helped business partners rely on his expertise to guide client recommendations. He is an insurance insider that has built dental networks, worked in operations management, designed dental plans, and opened markets. In 2013, he founded Practice Quotient, which specializes in dental insurance PPO network contract analytics and reimbursement guidance, representing the dental provider. As a national public speaker, Patrick educates doctors on how dental managed care participation impacts up to 50% of practice revenue, the importance of diligent contract management, and how to develop criteria specific to a patient acquisition strategy for choosing the best carrier business partners.
Disclosures: No relevant financial relationships were disclosed.
Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.5 continuing education credit(s).
AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680
The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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