Insurance Credentialing 104

In this session, we will explore the advanced components of the provider enrollment process with a focus on operational efficiency and compliance. Key topics will include tracking enrollment timelines, navigating healthcare plans and product structures, and managing provider data through reporting and rostering tools. We will also delve into government payer processes and requirements, highlighting the distinctions between commercial and public programs.

Attendees will gain practical insights into streamlining enrollment workflows, ensuring data accuracy, and maintaining alignment with regulatory standards across the various payers.

Learning Objectives: -

Identify key timelines, payer requirements, and documentation needed to successfully complete provider enrollment across commercial and government health plans.

Demonstrate an understanding of effective tracking, reporting, and rostering practices to ensure compliance and data accuracy throughout the provider enrollment process

Areas Covered:-

• NPI
• NPPES
• Medicare
• Medicaid
• Credentialing
• Enrollment
• Locums
• Enrollment Process
• Provider Rosters
• Timeline tracking
• Reporting
• Turnaround Time
• CAQH

Background: -

Build on the credentialing and enrollment processes you have already learned and implemented.

Who Will Benefit? 

• Practice Managers
• PESC
• CPMSM
• Revenue Cycle
• Directors
• CFO
• Credentialing
• Provider Enrollment
• EFT Enrollment
• Operations.