Partner Application - Credentialing Genie

1. CONTACT INFORMATION

Full Name*

Email Address*

Phone Number*

Company Name*

Job Title

Website

2. PARTNERSHIP TYPE

Which partnership model interests you?*

Referral Partner

Refer clients and earn one-time rewards.

Strategic Reseller Partner

Resell Genie services and set your own prices.

White-Label / Technology Partner

Integrate Genie into your platform with your own brand.

3. BUSINESS INFORMATION

What best describes your business?*

How many dental offices do you currently serve?*

Which states do you primarily serve? (Select all that apply)

California

Texas

Florida

New York

Arizona

Nationwide

Other

4. SERVICES YOUR CLIENTS NEED

Which services are your clients most likely to need? (Select all that apply)

PPO Credentialing Medicaid Enrollment New Practice Setup Re-Credentialing Medicare Enrollment Insurance Contracting CAQH Management Fee Schedule Negotiation Provider Enrollment

5. REFERRAL POTENTIAL & OPERATIONAL DETAILS

Approximately how many referrals could you send annually?*

Do you currently offer credentialing services?*

Yes, we do in-house

No, we do not

We outsource to another company

How many credentialing applications do you expect monthly?*

Do you want Genie to bill the client or bill your company?*

Who will provide client support?*

Do you need Genie branding, co-branding, or full white-label service?*

6. ADDITIONAL INFORMATION

Tell us about your business and how you help dental practices.

7. AGREEMENT

I certify that the information provided is accurate, agree to be contacted regarding Credentialing Genie partnership opportunities, and understand that submission of this application does not guarantee acceptance into the Partner Program.*

Your information is secure and will never be shared.

Referral Partner

Earn one-time referral rewards for every client we serve.

Strategic Reseller Partner

Resell Genie services and set your own prices to scale your business.

White-Label / Technology Partner

Integrate Genie into your platform with your own brand.

Why Partner With Us?

U.S.-Based Credentialing Experts
HIPAA Compliant & Secure
Fast Turnaround Times
Dedicated Partner Support
Trusted by 1,200+ Practices

Let's Grow Together

More Patients

More Revenue

Save Time

Trusted Experts

Referral Partner

Strategic Reseller Partner

White-Label / Technology Partner

Referral Partner

Strategic Reseller Partner

White-Label / Technology Partner

Why Partner With Us?

Questions?