> ## Documentation Index
> Fetch the complete documentation index at: https://dso.getlemma.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Track licenses, revalidations, and expirables
> One tracking system for dental licenses, DEA and sedation permits, CAQH attestation, Medicaid and DBA revalidation, payer recredentialing cycles, and DSO registration renewals.
A dental support organization (DSO) and its professional entities may track hundreds of deadlines across entities, dentists, and payers. A lapsed license, CAQH attestation, or Medicaid revalidation can interrupt billing. This guide builds a central tracking system.
## What has to be tracked
### Per dentist
| Item | Cadence | Lead time |
| -------------------------------------------------- | ----------------------------- | --------- |
| State dental license | 1–3 years, per state | 60 days |
| DEA registration | 3 years | 60 days |
| State controlled substance registration | Varies | 60 days |
| Sedation / anesthesia permit, where held | Per state board | 90 days |
| Specialty board certification, where held | Per board | 90 days |
| **CAQH attestation** | **\~120 days** | 14 days |
| Malpractice coverage | Annual | 60 days |
| Continuing education hours | Per state board renewal cycle | 90 days |
| CPR/BLS certification, where the board requires it | 2 years | 30 days |
Track credentials for the rest of the clinical team in the same system. These may include hygienist and assistant licenses, radiography credentials, and local-anesthesia certifications where the state issues them.
### Per dentist per payer
| Item | Cadence | Lead time |
| ---------------------------------------------------------------------------------------- | --------- | --------- |
| Commercial recredentialing for each carrier and **each Delta member company separately** | \~3 years | 90 days |
| Dental benefit administrator (DBA) recredentialing | \~3 years | 90 days |
### Per entity
| Item | Cadence | Lead time |
| ------------------------------------------------------ | -------------------------------- | --------- |
| **Medicaid revalidation** | At least 5 years, state-specific | 90 days |
| Medicare revalidation, **if enrolled** | 5 years (3 for DMEPOS) | 90 days |
| DSO registration renewal, where the state requires one | Per state (e.g. Texas: annual) | 60 days |
| Payer contract renewal / fee schedule review | Annual | 90 days |
| State annual report | Annual, per state | 60 days |
| Franchise tax | Annual, per state | 30 days |
| Registered agent renewal | Annual | 30 days |
| Business licenses | Varies | 30 days |
| Radiography equipment registration, where required | Varies by state | 60 days |
Several states require a role-specific DSO, manager, business-entity, or owner registration with annual or periodic renewal. See [Register a DSO](/guides/compliance/register-a-dso) for the applicable categories.
### Ongoing, monthly
| Check |
| ----------------------------------------------------------- |
| **OIG LEIE** exclusion screening, all staff and contractors |
| **SAM.gov** debarment screening |
| State Medicaid exclusion lists |
| License status spot-check |
## The two highest-risk items
**CAQH attestation** expires roughly every 120 days and, when it lapses, makes profiles invisible to payers **mid-credentialing**. It is the highest-frequency item on this page and the one most often missed.
**Medicaid revalidation** notices go to the enrollment correspondence address on file with the state. Dental benefit administrators may run separate recredentialing cycles. Monitor every address and portal because a missed notice can lead to termination. Groups that bill Medicare should also check due dates in the [Medicare Revalidation Lookup Tool](https://data.cms.gov/tools/medicare-revalidation-list) instead of waiting for a PECOS notice.
## Build the system
| Scale | Tool |
| ---------------------------- | --------------------------------------------------------------------- |
| 1–5 dentists, 1 entity | Spreadsheet plus calendar reminders |
| 5–20 dentists, 1–3 entities | Spreadsheet plus a task system, or entry-level credentialing software |
| 20+ dentists, or 3+ entities | **Credentialing software** |
Consider a credentialing system once the grid reaches several hundred rows or the team can no longer review changes and exceptions reliably.
Six columns minimum: **Item · Entity or person · Jurisdiction or payer · Due date · Lead time · Owner**.
Add status and a last-verified date. Give each Delta member company and dental benefit administrator its own row for each state.
A reminder on the due date is a reminder you're late. Use the lead times above.
"Operations" is not an owner. A person is. Include a backup for anything whose lapse stops revenue.
Add "review the next 60 days of the compliance calendar" to the month-end close checklist.
Each quarter, compare a sample with primary sources such as the dental board's license lookup, the state Medicaid portal, and CAQH. The check can catch data-entry mistakes in the grid.
Add a dentist before their start date. For an acquisition, build the new practice's rows during diligence so deadlines are already assigned at closing.
## Recovering from a lapse
| Lapse | Immediate action |
| --------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Dental license expired** | **Stop the dentist from practicing.** Renew immediately. Assess claims billed during the lapse: they may be unbillable and may need to be refunded. |
| **CAQH attestation lapsed** | Re-attest immediately; notify payers with pending applications |
| **Medicaid or DBA revalidation missed** | Submit immediately; termination is possible and reinstatement may not be retroactive |
| **Malpractice lapsed** | Stop clinical work until reinstated; notify payers if coverage falls below their minimums |
| **DEA expired** | Stop prescribing controlled substances immediately |
| **Sedation permit expired** | Stop sedation cases immediately; reschedule or refer |
| **Recredentialing missed** | Contact the payer; you may be terminated from the network |
| **Annual report missed** | File immediately with any late fee, before administrative dissolution |
**A lapsed license means claims for services during the lapse may be unbillable, and services already paid may be subject to refund.** Discovering an overpayment starts the 60-day report-and-return clock for Medicaid (and Medicare, where you participate). See [Report and return overpayments](/guides/compliance/report-and-return-overpayments).
## Verify it worked
* [ ] Every item above is in the tracking system
* [ ] Delta member companies and DBAs tracked as separate rows per state
* [ ] Alerts set on lead time, not due date
* [ ] Named owner and backup per row
* [ ] Monthly review is part of the close checklist
* [ ] Quarterly primary-source spot-check running
* [ ] Enrollment correspondence addresses monitored by a named person
* [ ] Monthly exclusion screening documented
* [ ] New hires, new entities, and acquired practices added at onboarding
## Common failure modes
| Failure | Consequence |
| ------------------------------------------- | ------------------------------------------------ |
| Spreadsheet outgrown but not replaced | Rows silently missed |
| Alerts on the due date | Always late |
| No named owner | Nobody acts |
| Delta tracked as one payer | A member company's recredentialing missed |
| Correspondence addresses unmonitored | Terminated enrollments discovered via denials |
| Exclusion screening at hire only | Post-hire exclusion undetected |
| Acquired practice's expirables never loaded | A whole location's obligations tracked by nobody |
| Grid never verified against primary sources | Records what was entered, not what's true |