Credentialing: Where is it headed?

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Recorded On: 09/29/2020

Credentialing: Where is it headed?

Mike Cole

Vice President of Insurance Plan Management

Dental Care Alliance

In April 1999, Mike Cole joined Dental Care Alliance (DCA), an NADP Associate member and one of the largest dental service organizations in the country. As vice president of Insurance Plan Management, Mike oversees the teams responsible for insurance relations, revenue cycling and the credentialing departments. Prior to joining DCA, he was a network manager for both Prudential Healthcare and United Concordia. With more than 30 years in the dental healthcare industry, he was instrumental in fostering partnerships between DCA and the insurance plans. Working together to achieve the best outcomes has led to creation of the NADP credentialing application, NADP-supported directory validation process and innovations with the patient experience. My received the Don Mayes Award at CONVERGE 2019.

Mike has been active in the NADP for the last eight years and has served on the Operations Workgroup, where he is currently the vice chair. Mike is a graduate of the University of Missouri – Columbia and is also a Certified Employee Assistance Professional (CEAP).

Bret Guenther, CEBS

CEO

Dentistat, Inc. & go2dental.com, Inc.

Bret is the President of Dentistat and President / Founder of go2dental and has overall responsibility for the companies. Bret has over 38 years in the Employee Benefit field, with 25 years in the dental benefits space. Bret’s background includes working for The Travelers Insurance Company and as a Principal at a Brokerage firm.

Dentistat provides Network Management services and is one of the largest dental Credentialing Verification Organizations. Dentistat has been certified by NCQA 7 times.

go2dental has been helping consumers gain access to valuable web-based information to help them make better choices concerning their overall oral health care. Go2dental provides dental plans with a customized member experience to improve member satisfaction and improve the client’s value proposition. go2dental has been in business for over 20 years and works with over 25 dental plans.

Bret earned his Bachelor of Science in Marketing from San Jose State University and his Certified Employee Benefits Specialist (CEBS) degree from The Wharton School of Business in Pennsylvania.

LeAnn Morris

Vice President of Business Relations

DentalXChange

Le Ann Morris is the vice president of Business Relations for DentalXChange and has been with the company for over 10 years with an additional 20 years of experience working as the western regional sales director for a medical clearinghouse. In her time at DentalXChange, Mrs. Morris has headed the team to launch Humana’s and United HealthCare’s all payer portals, as well as the national launch of Delta Dental Plan Association’s ERA solution. She has also led the team to expand DentalXChange’s web based, credentialing platform, DDS Enroll and recently completed multiple implementations with Delta Dental payer networks, expanding DDS Enroll to seven states; with 4 more plans scheduled for implementation by early 2021. She has been supporting the DSO market for over a decade and sees credentialing as a major need. Mrs. Morris has been extremely active in the dental community, including being the NDEDIC Committee Chair in 2010 and a pivotal leader in Uniting the Industry, where providers and payers joined together to improve electronic delivery of eligibility and to reduce costs to all parties. Organizations are looking for innovative, dental driven tools and for over 30 years, Mrs. Morris has been leading the development and launch of these products.

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Credentialing: Where is it headed?