Credentialing 101: A Detailed Guide to Provider Credentialing

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Presenter: Alina Mineyli, Senior Credentialing Specialist

Date: Thursday, August 13, 2026

Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT

Duration: 60 minutes

Course Description

Credentialing 101: Get Provider Credentialing Right in 2026 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 Outcomes

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

What is Credentialing & Why It Matters
Key Systems & Documents
NPI
CAQH ProView
PECOS
Availity & Payer Portals
Supporting Documents
The Credentialing Process (Phases)
Laying the Groundwork for Success
Specialty-Based Variations
Physicians (MD/DO)
Therapists
Optometrists
Facilities
DME Providers
Multistate Credentialing & Medicaid
Insurance Types
Maintaining Communication
With Providers & Their Team
With Payers
Efficiently Communicating Progress
What Data to Track?
Tracking Checklist
Common Mistakes to Avoid
Escalating Issues with Payers
Timeline Realities, Denials & Re-Credentialing
Timeline Realities vs. Best Case
Denials & Appeals
Credentialing / Maintenance
Tools & Technology
Staying Current & Thinking Strategically
Strategic Planning & IPA Opportunities
Live Q&A Session

Recommended Participants

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

About the Presenter

Alina Mineyli is a Senior Credentialing Specialist with extensive experience in Medicare, Medicaid, Commercial, and Medicare Advantage enrollment processes across multiple states. She specializes in structured verification workflows, system alignment across CAQH, NPPES, and PECOS, revalidation monitoring, and strategic payer contracting.
Alina is an active member of the Healthcare Business Management Association (HBMA) and contributes to ongoing education and professional development initiatives within the credentialing and revenue cycle community. She is passionate about sharing practical, real-world credentialing strategies that help organizations reduce delays, protect revenue, and strengthen compliance infrastructure.
With years of hands-on experience navigating CMS regulations, MAC requirements, panel limitations, IPA relationships, and ownership disclosures, Alina focuses on building proactive credentialing systems that reduce preventable delays and improve approval timelines.
Her approach emphasizes precision, alignment, and strategic planning — transforming credentialing from a reactive administrative task into a structured compliance framework that supports long-term organizational growth.

Additional Information

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

System Requirement:

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 an On-Demand webinar. Use it as a training tool at your convenience.

For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com
Address: 651 N. Broad Street, Suite 206, Middletown, DE 19709

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