Event Materials (Key Required)
Credentialing 101: A Detailed Guide to Provider Credentialing is a foundational training session designed for professionals entering the world of healthcare provider credentialing. Whether you’re onboarding your very first provider or expanding your services across multiple states and specialties, this webinar will equip you with a comprehensive understanding of the credentialing lifecycle.
Participants will gain in-depth knowledge on how to prepare and submit credentialing applications, understand payer requirements, and navigate the varying processes based on provider types including mental health professionals, optometrists, allied health professionals, medical doctors, facilities, and ancillary services.
We’ll break down the essentials of insurance panelling, such as how to set up and maintain CAQH profiles, utilize NPPES for NPI data, register and navigate PECOS, and manage key portals like Availity. You’ll learn how to interpret insurance terminology, track credentialing progress, and work effectively with insurance representatives—distinguishing between national carriers, local HMOs, and union plans.
This course emphasizes strategic planning, communication with clients, compliance best practices, and smart use of software tools to ensure credentialing stays organized, timely, and successful. We’ll also explore how credentialing professionals can think outside the box, identify IPA opportunities, and stay current with evolving insurance guidelines.
Learning Objectives:
- Understand the complete provider credentialing process and its phases
- Identify and explain key terms, systems, and documents involved (e.g., NPI, CAQH, PECOS, Availity, W-9, malpractice insurance)
- Recognize how credentialing requirements vary by provider type (e.g., behavioural health vs. vision vs. facility-based care)
- Navigate multistate credentialing and licensing considerations
- Distinguish between insurance types (local HMO, national plans, and unions) and understand who the reps are
- Establish and maintain strong communication with clients and payer reps to manage expectations and streamline credentialing timelines
- Build a credentialing plan of action with due dates and progress tracking methods
- Leverage technology and software tools to organize, automate, and monitor credentialing workflows
- Stay current with insurance news and updates to reduce denials and anticipate changes
- Learn what to avoid during credentialing and common pitfalls that delay approvals
Areas Covered in the Session:
- Credentialing Basics: What is credentialing and why it matters for in-network status
- Key Systems & Documents: Understanding NPI (Type 1 & 2), Tax ID, CAQH, PECOS, W-9s, and Availity registration
- Credentialing Phases: Intake, application prep, submission, payer follow-ups, and contract receipt
- Specialty-Based Variations: Key differences in credentialing workflows for MDs, therapists, optometrists, facilities, and DME providers
- Multistate Credentialing Tips: Licensure rules, Medicaid enrollment strategies, and managing overlapping timelines
- Understanding Insurance Types: Comparing national plans (e.g., UHC), local HMOs (e.g., Fidelis), and union plans (e.g., 1199)
- Client Communication & Expectation Management: Setting up a transparent timeline and consistent updates
- Insurance Representatives 101: How to locate reps, build rapport, and understand the payer’s internal hierarchy
- Common Mistakes to Avoid: What you can’t do—e.g., using incorrect NPI types, wrong group vs. individual applications, etc
- Tools & Technology: Credentialing CRMs (e.g., CredyApp, Modio, CAQH ProView), spreadsheets, portals, and reminders
- Staying Current: Best practices for tracking payer updates, newsletters, industry alerts, and government guidelines
- Thinking Outside the Box: Strategic planning—adding new plans, exploring IPA relationships, and creating credentialing roadmaps
- Live Q&A Session
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Suggested Attendees:
- Credentialing and Enrollment Specialists
- Credentialing and Enrollment Experts
- Credentialing and Enrollment Leaders
- Healthcare Administrative Teams, Personnel
- Practice Managers and Administrator
- Healthcare Billing Specialist
- Staff Providing NPI Support, NPPES Support
- PESC, CPMSM, CPCS
- Staff Providing CAQH Support
- Clinic Managers
- Allied Health Providers
- Advance Health Practitioner
- Credentialing
- Enrollment
- Office Managers
- Operations
- Revenue Cycle
- Coders
- Clinical Directors
- Practice Owners
- Claims Teams
- MSPs
Presenter Biography:
Alina Mineyli is the Senior Credentialing Specialist at WCH Service Bureau, Inc., with extensive expertise in insurance credentialing, contract negotiations, and provider enrollment. She specializes in securing provider enrollments, managing re-credentialing, and resolving closed panel challenges for a wide range of healthcare providers, including multi-specialty groups, laboratories, pharmacies, and DME suppliers.
A strong advocate for healthcare rights, Alina has successfully negotiated contracts, facilitated reinstatements, and streamlined credentialing processes, ensuring providers can expand their networks and deliver quality care. Her strategic approach and in-depth payer knowledge have strengthened WCH’s credentialing services, making her a trusted partner in payer-provider negotiations.
She graduated with a Bachelors of Arty in behavioural Neuroscience and Medical Interpreter in the Hunter College of the City University in new York.
Additional Information:
System Requirement:
- Internet Speed: Preferably above 1 MBPS
- Headset: Any decent headset and microphone which can be used to hear clearly
For more information, you can reach out to the below contact: Toll-Free No: 1-302-444-0162 Email: care@skillacquire.com
Purchase Order Form – Click Here to download PO form.
Snippet From Our Previous Session
Frequently Asked Questions:
HOW MUCH TIME DOES IT TAKE TO RECEIVE THE DVDs/ FLASH DRIVE? +
For DVDs/ FLASH DRIVE – It will take around 7 working days.
CAN I PLACE AN ORDER ON CALL? +
Yes, you can call our toll-free number 302-444-0162 and ask our representative for the enrollment. Alternatively, you can also mail us at care@skillacquire.com.
CAN I PURCHASE ANY OF YOUR TRAINING FORMATS, AT ANY TIME? +
For DVDs/ FLASH DRIVE – Yes, you can place the order at care@skillacquire.com using the order brochure or can call us at our toll-free number 302-444-0162.
DO I REQUIRE A COMPUTER FOR ATTENDING A LIVE COURSE? +
The system requirements are quite basic: OS: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6 Internet Speed: Preferably above 1 MBPS Headset: Any decent headset and microphone which can be used to talk and hear clearly, in case of live course you can raise questions using a microphone.
HOW CAN I BECOME FACULTY AT SKILLACQUIRE? +
Please share your detailed CV with us and our team will screen the best faculty for the specific field.
HOW CAN I GET ACCESS TO THE LIVE TRAINING? +
You can access the live training using Joining Link or Dial-In Number. To get the joining link, you can click on the conference materials on the product description page, and enter your email address and password that you received in your email.
We will also send you the joining link or dial-in number to the registered email address 2-3 days prior to the live training. You can simply click the joining link to join the live training.
HOW CAN I MAKE A BULK PURCHASE? +
You can call our customer service department at 302-444-0162 and may also avail some discounts on the bulk orders.
WHAT’S THIS DIFFERENT FORMAT? +
- Live (One Attendee) – Only 1 person will be able to join the webinar
- Live (2 to 4 Attendees) – Upto 4 persons are allowed to join the webinar
- Live (5 to 10 Attendees) – Upto 10 persons are allowed to join the webinar
- On-Demand Recording (One Attendee) – Webinar recording link will be provided for a single attendee
- On-Demand Recording (Multiple Attendees) – Webinar recording link will be provided that can access by more than one person
- DVD – DVD will be shipped physically to the address provided
- Flash Drive – Flash drive will be shipped physically to the address provided
- Live + DVD – This allows you to attend live webinar plus you also get DVD shipped to the address provided
- Replay + FLASH DRIVE – Allows you to get webinar recording link plus you also get DVD shipped to the address provided
- Live + REPLAY + DVD – This allows you to attend live webinar plus you also get webinar recording to your email and DVD shipped to the address provided
WHAT CERTIFICATION DO I GET POST THE TRAINING? +
After successful completion of the training, you will be awarded the course completion certificate (on request). The certifications/ recertifications should be mentioned under the description of every course.
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}Attendee’s Reviews from the Previous Session:
1 Month ago By:- Cheryl Colbert
I thought the information was great. It was very informative and I would like to review the webinar again.
2 Weeks ago By:- Stephanie Janes
I really enjoyed the presenter. She was extremely knowledgeable and added in some humor.
5 Days ago By:- Liza Tan
Good presentation. Speaker was very upbeat which made paying attention easy.