Delegated Credentialing - Best Practices

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Recorded On: 10/06/2021

Learn more about best practices in delegated credentialing from the perspectives of both plans and DSOs. Panelists will discuss ways to streamline processes and foster positive relationships for both plan to plan, as well as plan to DSO credentialing delegation.

Theresa Bacon

Director Provider Relations

Aspen Dental Management

Theresa Bacon joined Aspen Dental Management Inc. (ADMI) in 2012 as the manager carrier relations and has served as director of insurance operations since March 2019.  Leading provider credentialing and plan enrollment for more than 900 Aspen Dental branded practices in 44 States.   Theresa currently serves as the chair of the DSO Advisory Council and has been a member of the NADP Operations and Codes Workgroups since 2015. Past volunteer experience includes Provider Directory Validation, CAQH and Delegated Credentialing Sub-WorkGroups.

With more than 20 years in the dental industry, prior professional experience includes leadership roles at Coast Dental Services and roles with general dentistry and endodontic private practices.

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).

Andrea Braykovich Garrett

Provider Network Management

Guardian Life

Andrea Braykovich Garrett has more than 20 years of experience in all facets of provider network management, including responsibility for credentialing and Dental Support Organization relationship management. While employed by DenteMax and Dental Network of America from 2000-2017, Andrea established delegated credentialing programs for both DSOs and network leasing plan partners. She also co-authored the NADP 2015 update to the Dental Plan Accreditation Standards for credentialing and credentialing delegation. Andrea is currently the director of Dental Networks for the Guardian Life Insurance Company of America.

Kristen Smith

Director, Provider Network Operations

United Concordia Dental

Kristen S. Smith is the director, Dental Network Operations at United Concordia.  She has overall leadership responsibility for all credentialing, delegated credentialing, provider data management and support functions.  

Kristen has more than 32 years of clinical and administrative dental experience.  She has worked for United Concordia for 30 years where she has held positions in professional relations, claims operations and audit, provider data management, quality/process improvement and project management. Prior to United Concordia she worked as a dental office manager and clinical dental assistant. 

Kristen has her Bachelor of Science from East Stroudsburg University, a PA Teaching Certificate, and is a Juran certified Six Sigma Black Belt.

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Delegated Credentialing - Best Practices