Meet Your Expert
Amy has over 25 years’ experience in the areas of accreditation, regulatory compliance, credentialing, process simplification/re-design, credentialing technology, CVO development/certification and delegation.
She has developed and presented various programs on credentialing and privileging processes, TJC, NCQA and URAC accreditation standards, and delegation and is the author of the recently published book, “Credentialing for Managed Care: Compliant Processes for Health Plans and Delegated Entities.”
Amy has been a National Association Medical Staff Services (NAMSS) member since 1991, became CPMSM certified in 1992 and received her CPCS certification in 2002. She is a NAMSS instructor and previously served as Chair of its MCO Task Force and Education Committee.
She is a former President of the Missouri Association Medical Staff Services and its Greater St. Louis Area Chapter. She holds a Bachelor’s of Science degree from the University of Missouri and a Master’s degree in Business Administration from Maryville University in St. Louis.
Training Sessions by Amy M. Niehaus
Don’t make the mistake of shoving provider credentialing monitoring aside in between reporting deadlines. If you do, the results can be financially and legally catastrophic. NCQA credentialing regulations REQUIRE you to monitor provider “sanctions, complaints and quality issues” that occur between re-credentialing submission deadlines. CMS and Joint Commission have expectations as well. This is true for facilities and mid-sized practices […]Learn More
A simple credentialing or provider enrollment application mistake can quickly turn into a nightmare. Your claims can be held, your payments delayed, your A/R write-offs increased, and you can even be denied payment altogether. You would think that accurately completing credentialing forms and enrollment applications would be quick and easy. Unfortunately, there are numerous missteps that can easily trip you […]Learn More
Getting your mid-sized practice designated as a credentialing delegate with commercial payers means you can eliminate payer plan enrollment delays, get paid faster, and avoid re-enrollment disasters. Payers want to hand off provider credentialing and re-credentialing to you, but you must have specific processes in place to qualify. Being a delegate gives you control to enroll new providers into your […]Learn More