Complete Guide to Provider Credentialing & Enrollment: Preparation And Tracking

Event Materials (Key Required)

Course Description

Are you Onboarding a new physician/ advanced-practice providers (APPs), or a previously credentialed provider/ advanced-practice providers (APPs) 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 delay 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 advanced-practice providers (APPs). 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/advanced-practice providers (APPs) revalidations, and providers currently credentialed joining a new group/ Tax ID.

Learning Objectives

• When is it possible to start credentialing for a new physician/ advanced-practice providers (APPs)?
• What is the process for Setup/ Maintenance/ Attestation of CAQH, PECOS, NPPES
• What are the required documents for credentialing a provider/ advanced-practice providers (APPs)?
• How to complete the payer applications for credentialing
• How to submit the provider/ advanced-practice providers (APPs) application package to payers
• Payer Specific requirements for applications and submission
• Payer Specific contact and submission information
• 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/ advanced-practice providers (APPs)
• How to link a credentialed provider to a new Tax ID

Areas Covered in the Session

• Credentialing Keys to Success
• Research
• Preparation
• Tracking
• Communication
• How do I start the process of credentialing a provider?
• Research
• Provider Research
• Payer Research
• Provider Welcome Package Documents
• Provider Enrollment Information Document
• Provider Document Checklist
• Provider CV Requirements
• Welcome Letter
• Description of Services
• Provider Contact Information Sheet
• CAQH Release and Attestation Form
• Payer Documents
• Payer/ State Applications
• Payer Contact Information
• Tracking Spreadsheet
• Provider Document Preparation
• Review All Documents for Accuracy, Dates, Infractions
• Create a Provider File
• Access Provider Logins
• Review Provider CV
• National Plan & Provider Enumeration System (NPPES)
• Identity & Access Management System
• Council for Affordable Quality Healthcare (CAQH)
• Provider, Enrollment, Chain & Ownership System (PECOS)
• Payer Document Preparation
• Application Preparation
• Payer Application Submission via Email/ Fax
• Payer Application Submission via Payer Website
• Linking of Provider/ Mid-Level Providers
• Linking a Provider/ Mid-Level Providers already PAR with the Payer
• Linking of Provider/ advanced-practice providers (APPs)
• Provider Re-Validation
• Tracking
• Document Tracking
• Application Tracking
• Provider Document Tracking Tools
• Provider Document Checklist
• Excel Tracking Spreadsheet
• Application Tracking
• Communication
• Minimize Impact
• Steps to Minimize Financial Impact
• Next Step after Provider Credentialing is Approved
• Information Storage
• Important Forms & Sheets

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

About the Presenter

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 Provider Credentialing and Contracting with Solor Inc., a third-party billing company providing physicians across all specialties full-service revenue cycle management, billing, and credentialing. Cati’s expertise extends through managing credentialing services, implementing successful enrollment programs, and contract/fee schedule negotiations for providers with all major payers. 

Additional Information

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to hear clearly

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

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

Email: care@skillacquire.com 

Purchase Order Form - Click Here to download PO form. 

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