Credentialing Specialist Certification

$250.00

Join us on Wednesday October 19th for the Credentialing Specialist Certification Workshop with Stacey Howe from 9:00am – 4:00pm at the Antler’s Hotel in Colorado Springs.

 

PLEASE NOTE: THIS WORKSHOP IS A SEPARATE PURCHASE FROM THE CONFERENCE. IF YOU WOULD LIKE TO ATTEND YOU CAN PURCHASE IT SEPARATELY OR ADD IT ON TO YOUR CONFERENCE PURCHASE.

Purchase of this workshop will include a box lunch.


**6 hours of CEUs approved by ArchProCoding and AAPC**

Credentialing is the process by which insurance carriers, facilities, and hospitals verify that a medical provider meets various quality and regulatory standards. Entities do this by reviewing items such as an applicant’s education, medical licensure, state and federal registrations, certifications, professional liability coverage, as well as many other documents. This time-consuming task requires precise attention to detail and follow through.  ArchPro’s credentialing team will ensure that your organization’s credentialing files are completed with accuracy and in compliance with regulatory and accreditation standards.

Enrollment refers to the process of requesting participation in a health insurance network and submitting required documentation to third party payers to gain approval into payer networks and allow providers to bill for services.

Objectives:  This certification is designed to increase your knowledge and competence in the credentialing and enrollment process.  You will be able to demonstrate your knowledge, skills, and abilities in the credentialing processes for your organization as well as effectively navigate the provider enrollment process.

Primary Audience: Credentialing Staff

Benefits: Credentialing staff will have the knowledge to:

·         Perform credentialing functions to meet documentation guidelines for compliance with regulatory standards and accrediting bodies

·         Credential physicians, allied health and other practitioners

·         Collect and maintain an accurate practitioner database and analyze verification information

·         Direct credentialing processes

·         Participate in audits of practitioner files for compliance

·         Collaborate with the organizations medical staff to develop and maintain facility specific credentialing standards and procedures

·         Understand payer requirements

·         Understand mistakes to avoid that delay payer enrollment

·         Understand how to navigate the payer enrollment process

Section Breakdown:

·         Credentialing overview

·         Committee and Staff Structure

·         Provider Credentialing

·         Primary Source Verification

·         Credentialing Committee Process

·         Provider Re-credentialing

·         Privileges

·         Ongoing Monitoring and Compliance

·         Telemedicine

·         CMS Regulations

·         Meeting Minutes

·         Fair Hearings

·         File Audit

·         Additional Requirements-Payer

·         Key Legal Cases

·         Putting it all together

·         Payer Enrollment Content

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