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Credentialing Tools: How to effectively prepare, submit, track, and finalize Provider Credentialing

Session Information:
By: Cati Harris, CBCS
Format: On-Demand Webinar
Duration of the training: 60 Minutes

Conference Material (Password Required)

Are you Onboarding a new physician/mid-level, or a previously credentialed provider/mid-level to your practice? Are you wanting to start building your onboarding program to credential providers in the future? If you answered yes, then this is the webinar for you! The onboarding process is filled with many different requirements. The slightest mistake in this process can result in significant reimbursement delays and rejection of your application package. Implementing a proven method for credentialing is the key to efficient, timely, and cost-effective credentialing. Failure to implement a strong credentialing program will impact the provider and practice revenue, leading to an affect on patient care. A successful onboarding program will ensure you avoid delays in reimbursement and interruptions to patient care.

During this session, Expert Cati Harris, CBCS, walks you through each step of the entire Onboarding credentialing process for physicians and mid-levels.  You will learn documentation requirements, application requirements, payer-specific requirements, document, and application package prep, credentialing package submission, setup and maintenance of CAQH, PECOS, NPPES, tracking of applications submitted to payers, and final steps once approval has been received. This will also include a review of provider/mid-level revalidations, and providers currently credentialed joining a new group/Tax ID.

Learning Objective:
  • When is it possible to start credentialing a new physician/mid-level?
  • What is the process for Setup/Maintenance/Attestation of CAQH, PECOS, NPPES
  • What are the required documents for credentialing a provider/mid-level?
  • How to complete the payer applications for credentialing.
  • How to submit the provider/mid-level application package to payers.
  • Payer Specific requirements for applications and submission.
  • Payer Specific contact and submission information
  • How to track provider/mid-level 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.
  • 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/mid-level.
  • How to link a credentialed provider to a new Tax ID
Areas Covered in the Session:
    • Provider/Mid-Level Documentation Requirements
    • CAQH and PECOS
    • Verification of provider/mid-level documents and licensure
    • Payer application requirements
    • State Requirements
    • Payer-specific enrollment information
    • Payer application submission
    • Application tracking
    • Medicare/Medicaid Enrollment
    • Efficient and Timely Communication
    • Contract and Fee Schedule Review
    • Steps to complete once provider/mid-level is approved by payer.
    • Sample forms provided
Suggested Attendees:
  • 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
  • Credentialing
  • Enrollment
  • Office Managers
  • Operations
  • Revenue Cycle
  • Coders
  • Clinical Directors
  • Practice Owners
  • Claims Teams
  • MSPs
Presenter Biography:

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.