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When onboarding a new midlevel/non-physician to your practice, the slightest mistake can result in significant reimbursement delays and rejection of your provider credentialing application package. To get your new midlevel/non-physician provider fully credentialed and contracted with payers, there are specific requirements, documents, and payer-specific requirements you must have right the first time. Failure to do so can impact your midlevel provider/practice revenue and greatly affect patient care. Even simple errors can get your set-up/transfer documents rejected by the payer leading to you starting the entire process over. It is important that your new midlevel/non-physician provider starts to see patients and gets paid as soon as possible.
During this session, Expert Cati Harris, CBCS, walks you through each step of the entire credentialing process for midlevel providers (PA, NP, Non-Physicians). You will learn documentation requirements, application requirements, payer-specific requirements, document, and application package prep, credentialing package submission, setup and maintenance of CAQH, PECOS, 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.
- When is it possible to start credentialing for a new mid-level?
- What is the process for Setup/Maintenance/Attestation of CAQH, PECOS
- What are the required documents for credentialing a midlevel?
- What are the specific requirements for the collaborative agreements?
- State licensing requirements for mid-levels
- Board Certification requirements for mid-levels
- What are the requirements for the supervising physician?
- What are the credentialing requirements for the supervising physician?
- How to complete the payer applications for credentialing?
- How to submit the mid-level provider application package to payers?
- Payer Specific requirements for applications and submission
- Payer Specific contact and submission information
- How to track midlevel 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 is 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?
- How to bill for a midlevel before credentialing is complete?
Areas Covered in the Session:
- Midlevel Documentation Requirements
- CAQH and PECOS
- Verification of midlevel documents and licensure
- Collaborative Agreements
- Supervising Physician Requirements
- Payer application requirements
- State Requirements
- Payer-specific enrollment information
- Payer application submission
- Application tracking
- Medicare/Medicaid Enrollment
- Efficient and Timely Communication
- Billing for a midlevel
- Contract and Fee Schedule Review
- Steps to complete once midlevel is approved by the payer
- Sample forms provided
- Credentialing and Enrollment Specialists
- Credentialing and Enrollment Experts
- Credentialing and Enrollment Leaders
- Healthcare Administrative Teams, Personnel
- Practice Managers
- Healthcare Billing Specialist
- Staff Providing NPI Support, NPPES Support
- PESC, CPMSM, CPCS
- Staff Providing CAQH Support
- Clinic Managers
- Allied Health Providers
- Advance Health Practitioner
- Office Managers
- Revenue Cycle
- Clinical Directors
- Practice Owners
- Claims Teams
About the Presenter
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 Credentialing/Contracting with Solor, Inc., a third-party billing company providing physicians across all specialties full-service revenue cycle management and billing. Cati’s expertise extends through managing credentialing services and contract/fee schedule negotiations for providers with all major payers.