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Format: On-Demand Webinar
Presenter: Yesenia Servin, CPMSM, PESC
Time: You can access the webinar anytime
Duration: 60 minutes
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If you want to keep your medical practice’s revenue flowing, your provider’s CAQH profile must be in compliance and up to date. You must accurately implement the mandatory New CAQH changes to get your enrollment approved and payor reimbursement flowing in.

During enrollment and credentialing processes both government and commercial payers use your CAQH profile. Complying with the 2023 changes is also vital to ensure you comply with the No Surprises Act requirements related to current and accurate provider directory listings. Failure to do so can result in heavy penalties violation (i.e., each incorrect directory listing).

This session will review a step by step each and every section in CAQH. Credentialing and enrollment specialists are to comply with all the implemented CAQH updates to avoid negative revenue impacts. Implement a solid process for maintaining your CAQH provider accounts and understand how to partner with your practitioners to be fully compliant and structured. Review attestation requirements to speed your re-credentialing turnaround time and create an internal process to easily track CAQH attestations and maintenance.

Learning Objective:

  • Identify if & how you should implement the new CAQH updates
  • Pinpoint the data fields & profile sections that will improve your enrollment process
  • Discuss the CAQH process connection to the billing claims submission & reimbursements
  • Know the new rules and guidelines for CAQH
  • Know how to maintain your CAQH provider accounts compliantly
  • Review attestation requirements to speed your re-credentialing turnaround time

Areas Covered in the Session

  • CAQH
    • What are new changes?
    • What is next step?
    • What to expect?
    • How to advocate?
  • Provider Profile
  • CAQH Practice Manager
  • Organization Profiles
  • CAQH Proview for Groups
  • Validate Locations for Errors and Suggested Changes
  • Limit TIN to One for Existing Practice Locations Currently
  • Streamlined credentialing process
  • Demographic and professional provider data administration processes
  • Real-time system validation
  • Provider specialties
  • Healthcare Organizations using CAQH
  • Avoid application delays
  • Impact the CAQH accounts have on your revenue cycle
  • Required professional documentation
  • Getting Started with CAQH Credentialing Portal
  • Initial CAQH Credentialing Requirement
    • Types of Information
    • Required Steps
    • Proper Materials
    • Manages information for Multiple Provider
  • Complete Process for Creating CAQH Account
  • Provider Data Portal
    • Personal Information
      • Profile Setup
      • Names, Address, Contact Info
      • Personal Identification Number
      • Demographics
      • Work Permit and Visas
      • Languages
    • Professional IDS
      • Professional Licience
      • DEA Registration
      • CDS
      • Medicare
      • Medicaid
      • ECFMG
      • USMLE
    • Profile Data
  • Education and Professional Training
  • Specialties
  • Practice Location
  • Hospital Affiliations
  • Credentialing Contacts
  • Professional Liability Insurance
    • Insurance Coverage
    • Current Insurance Policies
    • Federal Tort Claims Act (FTCA) Coverage
  • Employment Information
  • Professional Information
  • Disclosure
  • Documents
  • Authorization Setting

Suggested Attendees

  • Credentialing Specialist
  • Provider recruiters
  • On-boarding professionals
  • Enrollment professionals
  • PESC
  • CPCS
  • Office manager
  • Practice manager
  • HR
  • Revenue Cycle
  • Claim Experts
  • CFO, Finance Leader, Revenue Cycle Leader
  • Healthcare Administrative Teams, Personnel
  • Healthcare Billing Specialist
  • Staff Providing CAQH Support
  • Clinic Manager
  • Allied Health Providers
  • Advance Health Practitioner
  • Credentialing
  • Enrollment
  • Coders
  • MSP’s
  • CAQH SpecialistCredentialing and Enrollment Specialists
  • Credentialing and Enrollment Expert
  • Credentialing and Enrollment Leaders

About the Presenter

Yesenia Servin is an expert in credentialing and provider/payer enrollment with over 24 years of experience in the healthcare industry. Yesenia has a deep understanding of Medicare & Medicaid enrollment and is a nationally certified credentialing manager and provider enrollment specialist. Through, YS Credentialing PLLC, Yesenia helps organizations develop and implement best practices guidelines and processes. Guides the credentialing and payer enrollment structure. Thrives on training and growing administrative, credentialing and enrollment healthcare professionals. Yesenia manages payer enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payer enrollment processes. Yesenia works with durable medical equipment, hospital and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations. Yesenia is a current Charter Oak University Faculty, NAMSS member, and is a current & past NAMSS Educational Conference Speaker, current trainer for The Chicago School of Professional Psychology trainer and a TMG Collaborator. Yesenia studied microeconomics and communications at NEIU and healthcare administration at Concordia University Chicago. Yesenia enjoys spending time with her family and pugs. She finds great joy in visiting and trekking the great US states and regions.

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