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The Importance of Due Diligence in Credentialing Dentists and Anesthesia Providers

Written by Duane Tinker (aka the Toothcop)

So, you've got a burning question: "Do doctors have any responsibilities when it comes to checking all the boxes on their license checklist?" Excellent question, indeed!


The Necessity of Credentialing

Regardless of whether you're part of a large healthcare organization or a smaller dental practice, due diligence in credentialing is essential. Hiring credentialed clinicians isn’t just a best practice; it’s a necessary safeguard. Even though we're in an era of advanced verification methods, fraudulent medical and dental professionals can still slip through the cracks. If they do, and a patient gets harmed, guess whose due diligence process comes under scrutiny? Yours. That’s why it’s important to take this seriously.


Not Just for Hospitals

While credentialing might be more closely associated with hospitals, it’s equally important for dental practices and Dental Service Organizations (DSOs). Due diligence is about minimizing liability and ensuring quality care. For further reading on credentialing, you might want to check out this article on Hospital Credentialing.


Recommended Steps for Credentialing

  1. Verify Government Photo ID: Confirm that the person is who they say they are.
  2. Dental License Verification: Cross-reference with state or federal databases to ensure the license is valid and up-to-date.
  1. DEA Registration: Verify that the provider is registered with the Drug Enforcement Administration, which is a requirement for prescribing controlled substances.
  1. BLS Certification: Make sure the Basic Life Support certification is current.
  1. ACLS or PALS Certification: Check the Advanced Cardiovascular Life Support or Pediatric Advanced Life Support certifications, as appropriate.
  2. Medical Malpractice Insurance: Confirm that the clinician has a valid policy. You can either establish a minimum requirement or adopt state standards, like those for Texas Medicaid.
  1. Exclusions Check: Make sure the clinician is not excluded from participation in federal or state healthcare programs.
  1. National Practitioner Data Bank Self-Query: Require the clinician to provide a self-query from the National Practitioner Data Bank.

 

Keep It Updated

Remember, credentialing is not a one-time event. Insurance companies and Medicaid re-credential providers every 2-3 years to ensure they're still up to standard. Your organization should do the same, for both liability control and quality assurance.

We hope this helps clarify the vital role of due diligence in credentialing. Doing it right is not just checking boxes; it's about ensuring quality and minimizing risk.


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