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Are you new to provider/mid-level credentialing? Do you want to implement a proven credentialing system? Do you want to “brush up” on your credentialing skills? If you answered yes, then this webinar is for you! Join expert Cati Harris, CBCS, as she provides you with a comprehensive guide to provider and mid-level credentialing. In this detailed program, you will learn how to setup/ maintain CAQH, PECOS, NPPES, I&A, Provider/ Mid-Level credentialing documentation requirements, verification of Provider/ Mid-Level documents, Payor application requirements, and the preparation/submission of payer credentialing applications packages.
You will be provided proven tracking tools to aid in provider document tracking/ verification, and payer application tracking. A set of over 10 various, fully customizable forms, letters, etc for provider documentation requirements, CV requirements, application submission, provider/ mid level linking, re-validation, and employment history requirements. Lastly, there will be a live question/ answer session at the end of the presentation.
Once you complete this session, you will have the detailed information you need to successfully begin credentialing providers/ mid-levels.
Learning Objectives
When is it possible to start credentialing for a new physician?
What is the process for Setup/Maintenance/ Attestation of CAQH, PECOS/ NPPES
What are the required documents for credentialing a provider?
How to complete the payer applications for credentialing.
How to submit the provider application package to payers.
Payer Specific requirements for applications and submission.
Payer Specific contact and submission information
How to track provider documentation and verify authenticity/active.
How to track submitted payer application packages.
Common processing times and how to identify flagged applications.
Tips to ensure your credentialing process are efficient and timely.
Process to complete once the payer has approved credentialing
How to review the proposed Fee Schedule and Contracts
How to efficiently communicate updates with the payer and provider.
Areas Covered in the Session
Credentialing Keys to Success
Research
Preparation
Tracking
Communication
How do I start the process of credentialing a provider?
Research
Provider Research
Payer Research
Provider Welcome Package Documents
Provider Enrollment Information Document
Provider Document Checklist
Provider CV Requirements
Welcome Letter
Description of Services
Provider Contact Information Sheet
CAQH Release and Attestation Form
Payer Documents
Payer/ State Applications
Payer Contact Information
Tracking Spreadsheet
Provider Document Preparation
Review All Documents for Accuracy, Dates, Infractions
Create a Provider File
Access Provider Logins
Review Provider CV
National Plan & Provider Enumeration System (NPPES)
Identity & Access Management System
Council for Affordable Quality Healthcare (CAQH)
Provider, Enrollment, Chain & Ownership System (PECOS)
Payer Document Preparation
Application Preparation
Payer Application Submission via Email/ Fax
Payer Application Submission via Payer Website
Linking of Provider/ Mid-Level
Linking a Provider already PAR with the Payer
Provider Re-Validation
Tracking
Document Tracking
Application Tracking
Provider Document Tracking Tools
Provider Document Checklist
Excel Tracking Spreadsheet
Application Tracking
Communication
Minimize Impact
Steps to Minimize Financial Impact
Next Step after Provider Credentialing is Approved
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 Provider Credentialing and Contracting with Solor, Inc., a third-party billing company providing physicians across all specialties full-service revenue cycle management, billing, and credentialing. Cati’s expertise extends through managing credentialing services and contract/fee schedule negotiations for providers with all major payers.
Snippet From Our Previous Session
Course Content
You can access all the webinar materials after successful payment