Credentialing for prospective dentists is performed according to standards that are similar to those promulgated by the National Committee for Quality Assurance.
The following credentials and qualifications are required for participation in our network:
Credentialing requirements |
Primary and/or secondary source verified through: |
State license |
BODEX |
DEA or Controlled Substance Certificate (except orthodontists) |
NTIS, Internet web site or hard copy |
Graduation from accredited dental school |
BODEX, ADA Master File* or copy of certificate |
Specialty training verification (if applicable) |
ADA Master File or copy of certificate |
Professional liability insurance |
Copy of declaration page or binder |
Controlled substance certificate (if applicable) |
BODEX, applicable state agency or copy of certificate |
Application and Contract |
Both must be signed by the dentist |
Malpractice and sanction history |
Provider narrative |
Onsite dental facility assessment for all DHMO general dentists; onsite visits for DHMO specialists and PPO dentists performed as needed |
All CIGNA Dental standards for dental facilities are verified onsite by trained network managers |
Review of utilization (profiling) data from CIGNA Dental's database |
Outliers reviewed by the regional dental directors for all PPO |
