Delegated Credentialing - Best Practices

Delegated Credentialing - Best Practices

Wednesday, September 22
2:00 PM - 3:15 PM (CT)

Session description coming soon

Theresa-Bacon.pngTheresa 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
VP of Insurance Plan Management, Dental Care Alliance

Mike Cole joined Dental Care Alliance (DCA) in April 1999 and is currently the vice president of Insurance Plan Management.  He oversees insurance relations, DCA’s Membership Plan and the credentialing and delegated credentialing departments.  Prior to joining DCA, Mike was a network manager for both Prudential Healthcare and United Concordia Dental.  Mike has more than 30 years working in the dental industry on both the plan side as well as for Dental Care Alliance.

 Mike has been instrumental in fostering partnerships between the plans and DSOs.  Working together to achieve the best outcomes has led to the creation of the NADP credentialing application, NADP supported directory validation process and innovations with patient satisfaction

Mike has been active with NADP for the last eight years and has served on the Operations Workgroup where he is currently the vice-chair. Mike received a Star Award from NADP in 2015 for his work on a standardized dental application.  He received the prestigious Don Mayes Leadership Award in 2019 from NADP and was the first DSO designee to be recognized.

Mike has served as co-chair on the Insurance Committee with the Association of Dental Support Organizations since 2020.  The Committee was formed in response to COVID-19 and it meets bi-weekly staying current with topics relevant to DSOs. 

Mike is a graduate of the University of Missouri – Columbia and is 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_500w.jpgKristen 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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