Stop Credentialing & Enrollment Delays – NCQA, TJC and CMS 2025 Updates
Course Description:
Updates, Updates, and more Updates! We have all heard by now, or seen the newest updates to the NCQA standards taking effect in just a few more months. It’s probably the most extensive list of updates in a long while. If you have some additional questions, want to understand the interpretations or intent of the changes, this webinar will help break it down to understandable and actionable terms. Although more specific to NCQA changes, we will also discuss updates in recent past from The Joint Commission and CMS just to name a few.
NCQA has recommended updates to the credentialing category of Health Plan Accreditation, Credentialing accreditation standards and Credentialing Verification Organization (CVO) Certification. Providers need to know what these changes are and how they impact mitigating risk at your organization. This session will address not only the changes in the NCQA standards, but the “why” behind those changes and the value they bring to your organization. These changes are not as scary as they may appear, and the time frames are not the only change.
Learning Objectives:
- Explain current modifications and updates to NCQA requirements
- Identify the changes in the NCQA standards relating to: - CVO Certification - Health Plan Accreditation – credentialing - Credentialing overall
- Discuss the operational needs and opportunities implied by NCQA requirements
- Help understand and interpret intention of the revised standards and how best to evidence compliance
- Discuss other accreditation body updates, including, but not limited to The Joint Commission and CMS
- Identify strategies to meet the new standards
Areas Covered in the Session:
- Internal Quality Improvement Process
- Agreement and Collaboration with Clients
- Protecting Credentialing Information
- Credentialing Policies
- Credentialing Committee
- Credentialing Verification
- Recredentialing Cycle Length
- Ongoing Monitoring
- CVO Certification
- Health Plan Accreditation
- Notification to Authorities and Practitioner Appeal Rights
- Assessment of Organizational Providers
- Live Q&A Session
Suggested Attendees:
- Hospital Directors
- Healthcare Providers – Physicians and NPPs
- Clinicians
- Credentialing Managers
- Credentialing Specialists
- Coordinators who contribute to credentialing activities
- Healthcare Consultants, Contractors, Delegates and Vendors of Health Plans
- Professionals in Compliance or Risk Management
- Professionals in Quality assurance/Improvement or Performance Measurement
About the Presenter:
With over 27 years of experience as a Medical Staff Professional (MSP), Larry DeHoyos, CPCS, PESC, stands as a trailblazer in the healthcare industry. Known for his deep expertise and forward-thinking approach, Larry has spent nearly three decades helping to push the boundaries in the Provider & Payer Credentialing spaces. His work spans across all 50 states and touches nearly every corner of the healthcare landscape, from health plans and managed care to outpatient surgical centers, laboratories, and beyond.
Larry is a respected speaker and member of the National Association of Medical Staff Services (NAMSS) and has contributed his expertise to numerous states and local NAMSS chapters in Massachusetts, Wisconsin, Michigan, Louisiana, Texas, and California. His insights have been shared on prominent platforms such as McKnight’s Long-Term Care News, NAMSS conferences, Decision Health’s National Provider Enrollment Forum, and countless other forums dedicated to the advancement of healthcare services.
Additional Information:
After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to talk and hear clearly
Can’t Listen Live?
No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
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