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Are you Onboarding a new physician/ advanced-practice providers (APPs), or a previously credentialed provider/ advanced-practice providers (APPs) to your practice? Are you wanting to start building your onboarding program to credential providers in the future? If you answered yes, then this is the webinar for you! The onboarding process is filled with many different requirements. The slightest mistake in this process can result in significant reimbursement delays and rejection of your application package. Implementing a proven method for credentialing is the key to efficient, timely, and cost-effective credentialing. Failure to implement a strong credentialing program will impact the provider and practice revenue, leading to an affect on patient care. A successful onboarding program will ensure you avoid delay in reimbursement and interruptions to patient care.
During this session, Expert Cati Harris, CBCS, walks you through each step of the entire Onboarding credentialing process for physicians and advanced-practice providers (APPs). You will learn documentation requirements, application requirements, payer specific requirements, document and application package prep, credentialing package submission, setup and maintenance of CAQH, PECOS, NPPES, tracking of applications submitted to payers, and final steps once approval has been received. This will also include a review of provider/advanced-practice providers (APPs) revalidations, and providers currently credentialed joining a new group/ Tax ID.
Learning Objectives
When is it possible to start credentialing for a new physician/ advanced-practice providers (APPs)?
What is the process for Setup/ Maintenance/ Attestation of CAQH, PECOS, NPPES
What are the required documents for credentialing a provider/ advanced-practice providers (APPs)?
How to complete the payer applications for credentialing
How to submit the provider/ advanced-practice providers (APPs) application package to payers
Payer Specific requirements for applications and submission
Payer Specific contact and submission information
How to track submitted payer application packages
Common processing times and how to identify flagged applications
Tips to ensure your credentialing process is 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/ advanced-practice providers (APPs)
How to link a credentialed provider to a new Tax ID
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 Providers
Linking a Provider/ Mid-Level Providers already PAR with the Payer
Linking of Provider/ advanced-practice providers (APPs)
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