Association encourages payers to adopt provisional credentialing policies

As part of continued efforts to address credentialing delays — a common administrative burden dentists face — the American Dental Association has released a new provisional credentialing toolkit for payers.

Through the toolkit, which was approved by the ADA Council on Dental Benefit Programs in May, the ADA encourages payers to adopt provisional credentialing policies that allow qualified dentists to begin treating plan members while final credentialing requirements are completed.

“The council recognized an opportunity — and a responsibility — to be proactive in advocating for new dentists as they enter practice,” said Shelley Olson, D.D.S., chair of the ADA Council on Dental Benefit Programs. “Following discussions at the 2025 ADA House of Delegates, it was clear that credentialing delays can create real barriers for dentists who are ready to care for patients but are not yet able to deliver and bill for services. This toolkit is intended to help reduce those delays while maintaining the safeguards patients and payers expect.”

While provisional credentialing can help address onboarding delays, it is not intended to be a substitute for full credentialing, according to the toolkit. The ADA continues to support rapid, end-to-end credentialing as the ultimate goal.

The toolkit addresses several topics, including the purpose of provisional credentialing, minimum credentialing safeguards, provisional participation eligibility and timing, and network and claims treatment during provisional participation, along with other framework criteria.

The toolkit states provisional credentialing should be limited to no more than 60 days while payers complete their full credentialing review and that payers should strive to complete their review within one week of receiving a clean and complete application.

The provisional credentialing toolkit complements the ADA Credentialing Service, powered by CAQH, which is available at no cost to all licensed U.S. dentists. The service enables dentists to maintain a single credentialing profile and securely share it with multiple dental plans, helping reduce administrative burden and streamline credentialing, recredentialing, onboarding and provider directory updates. The ADA encourages dentists to regularly review and update their credentialing records to ensure information remains accurate and to help avoid enrollment and reimbursement delays.

“Together, these resources demonstrate the ADA's ongoing commitment to helping dentists spend less time navigating administrative obstacles and more time caring for patients,” Dr. Olson said.