User Types

• Team Member: Office staff, managers, or assistants who handle administrative work in a Business, such as checking eligibility, submitting claims, and helping Practitioners credential. Permission levels set by an Administrator control what each Team Member can do.
• Practitioner: The dentist or provider being credentialed and under whom services are delivered. Each Practitioner has their own account tied to their NPI and a unique email address.
• Payer: The insurance company or plan that covers patients and pays claims. Payers also subscribe to credentialing information through the Dental Hub.
• General: A basic account for someone who is not a Practitioner or Team Member and is not setting up a Business. A General user can explore the Dental Hub and, when a Practitioner delegates credentialing to them, complete credentialing work on that Practitioner's behalf, everything except the final attestation.

Other Terms

• Administrator (Dental Hub Administrator): The highest Team Member permission level for a Business. Administrators control what other Team Members can see and do, manage EFT accounts, and oversee Business setup.
• Attestation: The Practitioner's legal confirmation that their credentialing application is complete and accurate. Only the Practitioner can attest; it cannot be delegated.
• Authorization (Prior Authorization): A request for a Payer to approve a service before it is provided, confirming it will be covered. Also called prior authorization.
• Benefits: What a patient's dental plan covers. Checking eligibility tells you whether a patient has active benefits on a given date of service.
• Billing Entity: A reusable profile combining your TINs, Billing NPIs, taxonomy codes, and payment addresses so you don't re-enter them for every submission. At least one is required for RCM.
• Billing NPI: An organizational NPI that represents your Business rather than an individual Practitioner. Used on claims when you bill under the Business. See NPI.
• Business: Your dental practice as set up on the Dental Hub. A Business holds your TINs, Locations, Practitioners, Team Members, and Billing Entities, and is required for Revenue Cycle Management.
• Claim: A request to a Payer for payment for services already provided to a patient.
• Credentialing: The process of verifying a Practitioner's qualifications, such as education, licenses, and malpractice history, so a Payer will accept them into its network. Verified to NCQA standards and runs on a three-year cycle.
• Credentialing Committee: The group at a Payer, or its administrator, that reviews a verified application and makes the final decision to approve a Practitioner.
• Delegate / Delegated User: A Team Member or other user a Practitioner has authorized to complete credentialing and directory work on their behalf. A delegate can do everything except the final attestation.
• Delegation: Assigning your credentialing and directory management tasks to a Business or an individual user, while you keep authority and oversight.
• Direct Deposit (EFT): Electronic Funds Transfer. Bank account information you can store and link to Billing Entities. Whether you enter it does not change how any Payer pays you.
• Eligibility: Whether a patient is currently covered by a plan on a specific date of service. The Dental Hub shows results in green, orange, or red.