Delegation with Payers – A Roadmap to Delegated Credentialing

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Course Description

If you work in payer enrollment or revenue cycle, chances are you’ve heard about delegated credentialing and its many benefits for an organization, such as increased revenue generation, shortened turnaround times for onboarding, and increased provider satisfaction to name a few. If you’ve considered delegated credentialing but are not sure if it’s the best option for your organization, this presentation is for you! We will review delegated credentialing and its impact on revenue cycle. We will discuss the advantages and disadvantages of delegated credentialing. The presentation will address the steps to becoming delegated with health plans and explain how to determine the feasibility of delegated credentialing for your organization. Lastly, we will discuss in detail the process of applying for and implementing a delegation agreement with contracted health plans and next steps after achieving delegation.

Learning Objectives

• Define Delegated Credentialing
• Discuss Delegated Credentialing’s Impact on Revenue Cycle
• Understand the Steps to Become Delegated with Health Plans
• Determine the Feasibility of Delegated Credentialing for an Organization
• Describe the Process of Applying for and Implementing a Delegation Agreement with Health Plans

Areas Covered in the Session

• Overview of the Delegated Credentialing Process
• Advantages and Disadvantages of Delegated Credentialing
• Determining the Feasibility of Delegated Credentialing for Your Organization
• NCQA Standards for Delegated Credentialing
• Staffing Analysis
• Pre-Delegation Process
• Delegation Process
• Live Q&A Session

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Suggested Attendees

• Credentialing Specialists
• Provider Enrollment Specialists
• Provider Enrollment Supervisors/Managers
• Revenue Cycle Manager
• CVO Manager/Director
• Chief Financial Officer
• Medical Staff Coordinator
• Practice Administrators
• Office Managers

About the Presenter

Tammy West is Sr. Director CVO Operations and Regulatory Compliance for The Hardenbergh Group. She brings 25 years of experience in healthcare administration and 16 years in Medical Staff Services. In her current role, Tammy pursued and successfully achieved NCQA certification for Hardenbergh Group’s CVO. Tammy specializes in CVO operations, provider credentialing, provider enrollment, quality analysis, quality improvement, quality auditing, delegation audits, and policy and procedure creation and implementation.

Prior to joining The Hardenbergh Group, Tammy was a consultant and independent contractor for hospitals, health systems, CVOs, locum companies and private practices across the United States. She has vast experience as an MSP, including credentialing specialist, provider enrollment specialist, medical staff coordinator, Medical Staff Manager, and CVO Director.

In previous roles, Tammy was a CVO Manager where the CVO achieved NCQA accreditation and delegated credentialing status with commercial payors during her tenure. Additionally, Tammy worked as a quality auditor for an NCQA certified managed care company and an Adjunct Instructor teaching medical office systems classes. Tammy has a BS in Human Services Management and a master’s in healthcare administration with a minor in Education. She is a member of the North Carolina Association Medical Staff Services and the National Association Medical Staff Services.

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

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

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 

This is a Live Virtual session.

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