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When onboarding a new provider to your practice, the slightest errors can result in significant reimbursement delays and rejection of your provider credentialing application package. To fully credential and contract the provider with payers, you must complete specific requirements, documents, and payer-specific requirements. Failure to do so can impact your provider/practice revenue and greatly affect patient care. Even simple errors can cause payers to delay or reject your application package. This can lead to you having to start over with the entire credentialing process. Your new provider must start seeing patients as soon as possible to lessen the financial impact.
During this webinar, Expert Cati Harris, CBCS, walks you through each step of the credentialing process for providers. You will learn documentation requirements, application requirements, payer-specific requirements, document, and application package prep, credentialing package submission, setup, and maintenance of CAQH, PECOS, and tracking of applications submitted to payers, and final steps once approval has been received. This will also include a review of provider revalidations. You will also learn how you can make your onboarding process more efficient and accurate to speed up your billing process and get paid more quickly.
Learning Objectives
When is it possible to start credentialing a new physician?
What is the process for Setup/Maintenance/Attestation of CAQH, PECOS
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/activity.
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.
The 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