Credentialing 101: A Detailed Guide to Provider Credentialing
Format: On-Demand Webinar
Presenter: Cati Harris, CBCS
Duration: 90 minutes
Course Description:
Are you wanting to learn the provider credentialing process? Are you looking for a complete guide to get you started with provider credentialing? Are you looking to update your process with a proven method with payer specifics? Are you wanting to build or update your current credentialing processes? If you answered yes, then you have found the webinar made just for you! Join expert Cati Harris, CBCS as she presents this detailed, comprehensive webinar teaching you to successfully credential your providers and mid-level providers. This webinar features a comprehensive step-by-step guide to provider credentialing including over 10 printable and customizable forms for payer/application cover letters, provider documentation requirements, Verification of Documentation, CV requirements, application submission, payer linkage, provider revalidation, employment history, and much more! You will be provided tracking tools to aid in the tracking/verification of provider documents and payer application tracking. Additionally, you will learn how to setup/maintain CAQH, PECOS, NPPES, and Identity & Management, credentialing documentation requirements, verification and validation of documents, payor application requirements, prep/submission of payer enrollment applications packages, and the key items to complete once the credentialing process is complete and approved. At the end of this information-packed webinar, you will have the opportunity for a live question/answer session.
Learning Objectives:
- When is it possible to start credentialing for a provider/mid-level?
- Critical information for beginning the credentialing process
- What are the required documents for credentialing a provider?
- How to Verify/Validate provider documents
- Tracking of Provider Documents
- Setup/Maintenance of the Provider File
- Payer-Specific Enrollment Information
- Setup/Maintenance/Attestation of CAQH, PECOS, NPPES, I&A
- How to complete the payer enrollment applications
- How to submit provider enrollment applications
- Payer Specific requirements for applications and submission.
- Payer Specific contact and submission information
- Tracking of submitted payer enrollment application packages
- Processing times and how to identify flagged applications.
- Effective, Timely Communication for updating application status with providers
- Process to complete once the payer has approved credentialing
Areas Covered in the Session:
- Provider Welcome Package
- Provider Documentation Requirements
- Verification/Validation of Provider Documents
- Provider Document Tracking
- Setup/Maintenance of Provider File
- Setup/Maintenance of CAQH, PECOS, NPPES, I/A
- Payer application requirements
- Payer application prep/submission
- Payer-specific enrollment information
- Payer application tracking
- Medicare/Medicaid Enrollment
- Provider Linkage to Payer
- Efficient and Timely Communication
- Steps to complete once the provider is approved by payer.
- Multiple Printable/Customizable Forms, Letters, Tracking Tools
Suggested Attendees:
- Credentialing and Enrollment Specialists
- Credentialing and Enrollment Experts
- Credentialing and Enrollment Leaders
- Healthcare Administrative Teams, Personnel
- Practice Managers
- Healthcare Billing Specialist
- Staff Providing NPI Support, NPPES Support
- PESC, CPMSM, CPCS
- Staff Providing CAQH Support
- Clinic Managers
- Allied Health Providers
- Advance Health Practitioner
- Credentialing
- Enrollment
- Office Managers
- Operations
- Revenue Cycle
- Coders
- Clinical Directors
- Practice Owners
- Claims Teams
- MSPs
About the Presenter:
Cati Harris, CBCS is a nationally certified credentialing, billing, and coding specialist, with over 20 years of experience in the healthcare industry. Cati is the Director of Credentialing/Contracting with Solor, Inc., a third-party billing company providing physicians and mid-levels across all specialties full-service revenue cycle management, billing, and credentialing/contracting. Cati’s expertise extends through managing credentialing services and contract/fee schedule negotiations for providers with all major payers.