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If you want to keep your medical practice’s revenue flowing, your provider’s CAQH profile must be in compliance and up to date. You must accurately implement the mandatory New CAQH changes to get your enrollment approved and payor reimbursement flowing in.
During enrollment and credentialing processes both government and commercial payers use your CAQH profile. Complying with the 2023 changes is also vital to ensure you comply with the No Surprises Act requirements related to current and accurate provider directory listings. Failure to do so can result in heavy penalties violation (i.e., each incorrect directory listing).
This session will review a step by step each and every section in CAQH. Credentialing and enrollment specialists are to comply with all the implemented CAQH updates to avoid negative revenue impacts. Implement a solid process for maintaining your CAQH provider accounts and understand how to partner with your practitioners to be fully compliant and structured. Review attestation requirements to speed your re-credentialing turnaround time and create an internal process to easily track CAQH attestations and maintenance.
Learning Objectives:
- Identify if & how you should implement the new CAQH updates
- Pinpoint the data fields & profile sections that will improve your enrollment process
- Discuss the CAQH process connection to the billing claims submission & reimbursements
- Know the new rules and guidelines for CAQH
- Know how to maintain your CAQH provider accounts compliantly
- Review attestation requirements to speed your re-credentialing turnaround time
Areas Covered in the Session:
- CAQH
- What are new changes?
- What is next step?
- What to expect?
- How to advocate?
- CAQH PROVIEW
- Provider Profile
- CAQH Practice Manager
- Organization Profiles
- CAQH Proview for Groups
- Validate Locations for Errors and Suggested Changes
- Limit TIN to One for Existing Practice Locations Currently
- Streamlined credentialing process
- Demographic and professional provider data administration processes
- Real-time system validation
- Provider specialties
- Healthcare Organizations using CAQH
- Avoid application delays
- Impact the CAQH accounts have on your revenue cycle
- Required professional documentation
- Getting Started with CAQH Credentialing Portal
- Initial CAQH Credentialing Requirement
- Types of Information
- Required Steps
- Proper Materials
- Manages information for Multiple Provider
- Complete Process for Creating CAQH Account
- Provider Data Portal
- Profile Data
- Personal Information
- Profile Setup
- Names, Address, Contact Info
- Personal Identification Number
- Demographics
- Work Permit and Visas
- Languages
- Professional IDS
- Professional Licience
- DEA Registration
- CDS
- Medicare
- Medicaid
- ECFMG
- USMLE
- Personal Information
- Profile Data
- Education and Professional Training
- Specialties
- Practice Location
- Hospital Affiliations
- Credentialing Contacts
- Professional Liability Insurance
- Insurance Coverage
- Current Insurance Policies
- Federal Tort Claims Act (FTCA) Coverage
- Employment Information
- Professional Information
- Disclosure
- Documents
- Authorization Setting
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Suggested Attendees:
- Credentialing Specialist
- Provider recruiters
- On-boarding professionals
- Enrollment professionals
- PESC
- CPCS
- CPMSM
- Office manager
- Practice manager
- HR
- Revenue Cycle
- Claim Experts
- CFO, Finance Leader, Revenue Cycle Leader
- Healthcare Administrative Teams, Personnel
- Healthcare Billing Specialist
- Staff Providing CAQH Support
- Clinic Manager
- Allied Health Providers
- Advance Health Practitioner
- Credentialing
- Enrollment
- Coders
- MSP’s
- CAQH SpecialistCredentialing and Enrollment Specialists
- Credentialing and Enrollment Expert
- Credentialing and Enrollment Leaders
Presenter Biography:
Yesenia Servin is an expert in credentialing and provider/payer enrollment with over 24 years of experience in the healthcare industry. Yesenia has a deep understanding of Medicare & Medicaid enrollment and is a nationally certified credentialing manager and provider enrollment specialist. Through, YS Credentialing PLLC, Yesenia helps organizations develop and implement best practices guidelines and processes. Guides the credentialing and payer enrollment structure. Thrives on training and growing administrative, credentialing and enrollment healthcare professionals. Yesenia manages payer enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payer enrollment processes. Yesenia works with durable medical equipment, hospital and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations. Yesenia is a current Charter Oak University Faculty, NAMSS member, and is a current & past NAMSS Educational Conference Speaker, current trainer for The Chicago School of Professional Psychology trainer and a TMG Collaborator. Yesenia studied microeconomics and communications at NEIU and healthcare administration at Concordia University Chicago. Yesenia enjoys spending time with her family and pugs. She finds great joy in visiting and trekking the great US states and regions.
This is a Live Virtual session.
A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.
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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.
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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.
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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.
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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
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- 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.
TESTIMONIALS
“Jim Sheldon-Dean’s insights on privacy and security were very much helpful to our team, it was great to learn from an instructor like him. Appreciate!” CHRISTINE JACOB MD, CDI SPECIALIST
“This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course.” MELISSA PRESTON, HEALTH INFORMATION MANAGEMENT STAFF
“The workshop was very insightful and made absolute sense in terms of the regulations and their compliance. I am thankful for having the opportunity to attend.”BARBARA CAPRIOTTY, REHABILITATION DIRECTOR
