Enrolling your practitioners with payers is critical to support a healthcare organization’s financial success, but it can be a very time-consuming and frustrating process.  A simple application mistake or an inefficient process can impact your organization’s ability to receive timely revenue due to claims being held, payments delayed or even denied.

During this webinar, expert speaker Amy M. Niehaus, CPMSM, CPCS, MBA, will assist participants to understand what the payer credentialing process entails and the CMS and NCQA requirements that must be followed, as well as methods to reduce lost revenue due to payer credentialing delays and implement efficient enrollment processes.

Learning Objectives:

Participant will be able to

  • Improve their organization’s revenue stream through timelier enrollment processes
  • Understand the difference between enrollment and credentialing
  • Understand the payer credentialing process and its impact on their enrollment process,
  • Decrease enrollment turnaround time by submitting complete applications that meet payer requirements under CMS and NCQA
  • Establish efficient enrollment processes by implementing leading practices that support payer credentialin
  • Identify solutions to enrollment challenges

Session Agenda:

  • Overview of payer credentialing vs provider enrollment
  • Identifying today’s enrollment challenges
  • Understanding payer requirements and its impact on your enrollment process
    • Payer workflows and timeframes
    • Required NCQA verifications
    • Additional CMS requirements
    • Approval options
    • Ongoing payer requirements
  • Enrollment solutions
    • Payer repository
    • Application completeness
    • Use of technology
    • On-boarding team
    • Integration with medical staff services
  • Q&A

Suggested Attendees:

  • Medical services professionals
  • Medical staff coordinator
  • Medical staff services director
  • Medical staff services manager
  • Credentials coordinator
  • Credentials specialist
  • Provider enrollment specialist

About The Speaker:

Amy M. Niehaus, MBA, CPMSM, CPCS, is an independent healthcare consultant with more than 25 years of experience in the medical services and credentialing profession. In her current role, she advises clients in the areas of accreditation, regulatory compliance, credentialing, process simplification and redesign, credentialing technology, credentials verification organization (CVO) development, and delegation. Niehaus has worked in multiple environments throughout her career, including acute care hospitals, CVOs, managed care organizations (MCO), health plans, and consulting firms. She has been a member of the National Association Medical Staff Services (NAMSS) since 1991.

She is currently a NAMSS instructor and previously served as chair of the association’s MCO Task Force, as well as chair and member of the NAMSS Education Committee. She is a former president of the Missouri Association Medical Staff Services and its Greater St. Louis Area chapter. Niehaus has been a speaker and educator since 2000, developing and presenting various programs to state and national audiences on credentialing and privileging processes, TJC, NCQA and URAC accreditation standards and survey preparation, CVO certification, provider enrollment and delegation. She has authored and contributed to a variety of industry-related publications, including NAMSS Synergy, The Greeley Company, Credentialing Resource Center, AHLA MedStaff News, and Becker’s Hospital Review. She is the author of the HCPro book Credentialing for Managed Care: Compliant Processes for Health Plans and Delegated Entities.


     ENDS ON

[wpcdt-countdown id=”10531″]

After Registration

You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.

System Requirement

Operating System: 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

Can’t Listen Live?
No problem. You can get access to On-Demand webinar. Use it as a training tool at your convenience.

For more information you can reach out to below contact:

Toll-Free No: 1-302-444-0162