Every Specialty, Every County, and Every Renewal
Dental plans have to prove adequacy against their state's standards, and for Medicaid, under the federal access rules in 42 CFR §438.68. States are required to set and enforce quantitative adequacy standards specifically for pediatric dental networks. Gaps in specialty coverage, like endodontics, oral surgery, and orthodontia, are a common driver of member complaints and regulatory scrutiny.
Every inaccurate listing is a possible compliance finding and a member who can't reach the dentist your directory promised. It's also a risk to your next Medicaid RFP or DOI filing.
That's why dental plans are turning to Salesforce Health Cloud, Data 360, and MuleSoft. With the right implementation partner, adequacy, recruiting, contracting, credentialing, and your directory all run on one connected platform.
Challenge
Dental specialty gaps stay open too long because adequacy, recruiting, contracting, credentialing, and directory updates run through disconnected manual handoffs.
Solution
Health Cloud, Data 360, and MuleSoft find gaps by specialty and geography automatically, connect recruiting and contracting, and verify credentials continuously.
Results
Network teams prove adequacy on demand, fill specialty gaps faster, and keep directories accurate for members and regulators.
The Challenge
Closing a single gap means identifying it, recruiting, contracting, credentialing, and updating the directory. Different teams. Different systems. Manual handoffs at every step.
Specialty Gaps That Linger
Recruiting and credentialing dental specialists through disconnected processes takes time. Meanwhile, members in underserved counties wait, and complaints pile up.
Status Lost in the Handoffs
Every time a provider moves from one team to the next, status can get lost and errors creep in. Nobody has a clear view of where a provider stands.
Inaccurate Directories
When directories get updated separately, and often late, they become inaccurate. Broader payer directory audits have found accuracy rates only around 29%.1 Dental networks face the same risk.
The Solution
We apply the same connected network lifecycle we build for medical plans to general, pediatric, and specialty dental networks.
Gaps Found Automatically
Data 360 calculates adequacy continuously against your state's standards and EPSDT requirements. Gaps get flagged by geography and specialty, including general, pediatric, orthodontic, oral surgery, and periodontic coverage. No more recalculating by hand every renewal cycle.
Recruiting and Contracting as One Motion
The moment a gap appears, targeted outreach to underrepresented specialties starts. Flow-driven contracting tracks every provider from first contact to signed agreement, and anyone who needs that status can see it.
Continuous Credentialing
MuleSoft connects credentialing to state dental boards, the NPI Registry, and DEA registration for ongoing primary-source verification. A lapsed license or sanction surfaces immediately.
A Directory That Stays Accurate
Health Cloud manages each provider's status from recruiting through onboarding. The directory pulls from that same system, and ongoing monitoring catches errors before they reach members.
The Results
Adequacy You Can Prove
With one connected platform, your network team can prove adequacy on demand. Specialty and pediatric gaps show up early, county by county, while there's time to fix them.
The time from identified gap to active provider gets shorter because recruiting, contracting, and credentialing finally work together. Your compliance team isn't exposed by data nobody owns.
Most importantly, members reach the dentist your directory said they could. That protects your standing with regulators and strengthens your position in the next Medicaid RFP or DOI filing.
Ready to See It Against Your Own Network?
Let's look at the gaps your current process is missing and talk through how fast you could close them.
Adequacy on Demand
Faster Specialty Recruiting
Accurate Directories
Request Free Consultation
Need adequacy on demand, faster specialty recruiting, accurate directories, and a partner who can help?
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