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Are you new to credentialing? Has it been a while since you credentialed a provider/ mid-level? Maybe you were asked to step into a new position in provider credentialing. If you answered yes to one of these questions, then this webinar is for you! Whether you are brand new to provider/ mid-level credentialing or have a few years of experience, the ability to provide Effective Credentialing is the most critical key to provider/ mid-level credentialing. During this session, Expert Cati Harris, CBCS, walks you through each step of the entire credentialing process for providers and 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.
Learning Objectives
When is it possible to start credentialing for a new provider/ mid-level?
What is the process for Setup/ Maintenance/ Attestation of CAQH, PECOS
What are the required documents for credentialing a provider/ mid-level?
What are the specific requirements for the collaborative agreements?
State licensing requirements for provider/ mid-levels
Board Certification requirements for provider/ mid-levels
What are the requirements for the (mid-level) supervising physician?
What are the credentialing requirements for the (mid-level) supervising physician?
How to complete the payer applications for credentialing?
How to submit the provider/ mid-levels application package to payers?
Payer Specific requirements for applications and submission
Payer Specific contacts and submission information
How to track provider/ mid-levels 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
Credentialing Keys to Success
How do I start the process of credentialing a provider?
Provider Research
Payer Research
Provider Welcome Package Documents
Provider Enrollment Information Document
Provider Document Checklist
Provider CV Requirements
Welcome Letter
Description of Services
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
Termination of a Provider
Document Tracking
Application Tracking
Provider Document Tracking Tools
Provider Document Checklist
Excel Tracking Spreadsheet
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 Credentialing/ Contracting with Solor, Inc., a third-party billing company providing physicians across all specialties full-service revenue cycle management, billing, and Provider/ Mid-Level Credentialing/ Contracting. 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 for life-time