3-Part Training: Credentialing Basics, Payer Enrollment & Payer Delegation

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Important: Please select a format for each part of this series below. Final discounted rate will be reflected once all selections are made.

Part 1: Delegation

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. The key is…

Credentialing 101 for Your Practice

The consequences of incorrect credentialing are extreme - terminated from payer networks and reductions in revenue. There are specific nuances that can trip you up. However, with a little guidance, you could…

Improve Provider Payer Enrollment Approvals

Getting and keeping your providers enrolled in the most popular payer networks is the only way to ensure the success of your practice. However, it can be complicated and time consuming, but it doesn’t have to be…

Whether you like it or not, credentialing and payer enrollment are evil necessities. But depending on your practice size, there are a variety of strategies you can implement that will help you improve your processes, get you paid faster and get rid of your credentialing and enrollment headaches.

During an immediately available online training session by credentialing expert Tracey Tokheim, she will walk you through the most important aspects of provider credentialing, and help you ensure everything sails through the approval process. Then, during her two must-have online training sessions, enrollment and credentialing expert Amy M. Niehaus, CPMSM, CPCS, MBA will show you how to improve your payer enrollment process, as well as how to set up and successfully maintain becoming a payer credentialing delegate (if you are a mid to large practice).

Instant Savings! Order the entire Credentialing 3-Part Payer Enrollment and Delegation series within the next 5 days, and you’ll save an additional $100 off the total cost. Or, if you prefer, you can order each session individually at the regular rate.


PART 1: Credentialing Basics: Everything Your Practice Needs

Available Immediately
Order the on-demand version and listen to it at your convenience

The consequences of incorrect provider credentialing are extreme. You can be terminated from payer networks, see dramatic reductions in new patients, and ultimately serious reductions in revenue.

Although correctly credentialing for your providers isn’t rocket science, there are specific nuances that can trip you up and lead to serious backlash. However, with a little guidance, you could avoid delayed payments due to credentialing errors, and ensure that your revenue keeps flowing.

That’s where credentialing expert, Tracey Tokheim, can help. During her 90-minute online training session, she’ll walk you through the most important aspects of provider credentialing, and help you ensure everything sails through the approval process.

Here are just a few of the step-by-step strategies you’ll receive by taking advantage of this 90-minute online training:

      • Proven process to overcome the top barriers to successful enrollment
      • Identify application red flags fast and stop them from hurting your revenue
      • Avoid missed deadlines with proven provider enrollment activity tracking
      • Master electronic database application processes
      • Pin down clear hand-offs to avoid details falling through the cracks
      • Implement proven expirables management and stop being dropped
      • Proven Initial Application Process Checklist to head off missed deadlines
      • Head off the most common references errors
      • And so much more…

Unlike hospitals that enlist full time credential professionals, most medical practices put this process on an existing staff member and just expect you to be able to do it. Well, you are not alone. By ordering this online training, you’ll get the insider information you need to file more accurate applications, and avoid delayed or lost reimbursement due to credentialing errors.

Order the 3-Part Series for $491 (Save $100)  |  Order Only This Training Session for $197


PART 2: Improve Provider Payer Enrollment Approvals

Available Immediately
Order the on-demand version and listen to it at your convenience

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 up (even if you have years of experience) – unless you know how to identify and rectify them.

That’s where credentialing and enrollment expert, Amy M. Niehaus, CPMSM, CPCS, MBA, can help. Amy will provide you with exactly what you need to do to more accurately, efficiently and effectively get your providers credentialed with the top payers. After listening, you’ll be able to get your providers credentialed and enrolled with payers quicker and easier to avoid any loss or delay to your reimbursement.

Here are just a few of the proven, plain-English tactics you’ll receive by taking advantage of this 60-minute online training:

      • Speed up approval of your enrollment applications to get paid faster
      • Head off re-credentialing errors that freeze up your reimbursement
      • Utilize NCQA credentialing tactics to avoid enrollment denials
      • Avoid provider work-history gaps from delaying provider approval
      • Prevent outdated attestations from holding up your enrollments
      • Improve your onboarding processes to speed up your approvals
      • Incorporate follow up systems that significantly reduce verification delays
      • And so much more…

REQUIREMENT: You must have a good understanding of credentialing and enrollment activities within a healthcare or physician organization to maximize your benefit from this presentation.

CEUs: This program meets AAPC guidelines for 1.0 CEU. On Demand product requires successful completion of a Post-Test for Core A for continuing education units.

Order the 3-Part Series for $491 (Save $100)  |  Order Only This Training Session for $197

PART 3: Master Payer Delegation to Speed Enrollment and Payments

Available Immediately
Order the on-demand version and listen to it at your convenience

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 payer plans almost immediately (so you get paid right away), and ensures that your current providers maintain enrollment without interruption.

The key is knowing how to set up and maintain your delegation process. This is where credentialing expert, Amy M. Niehaus, CPMSM, CPCS, MBA, can help. During her 60-minute online training, Amy will walk you through how to set up your own delegation program and provide you with proven strategies to manage it seamlessly and successfully.

Here are just a few of the proven, plain-English tactics you’ll receive during this 60-minute online training:

      • Pin down what payer contract delegation clauses really give you control
      • Determine which NCQA rules you need to implement to comply
      • Reduce time to conduct primary source verifications
      • Uncover hidden terms in your delegate contract that can cause you problems
      • Pinpoint who to include in your credentialing committee, and what they really do
      • Master what constitutes as a clean file, and why it’s so important
      • Set up re-credentialing cycles that keep your providers enrolled, and you compliant
      • Identify key documentation points that help you master a program audit
      • Illustrate your quality with payer notifications and appeal processes
      • Decide on the best method to manage your roster files to ensure top quality
      • And so much more…

IMPORTANT: This is NOT a “how to” on credentialing providers. This session is a how-to on setting up and maintaining a delegation program. You must have a good understanding of credentialing activities within a healthcare or physician organization to gain the biggest benefit from this session.

Order the 3-Part Series for $491 (Save $100)  |  Order Only This Training Session for $197

Meet Your Experts

Tracey TokheimAperture Credentialing, LLC

A recognized leader known for crafting strategic vision to achieve business goals through the development and execution of process efficiency, out-of-the box thinking, and key management partnerships.

While serving as a Product Line Senior Director with Aperture Credentialing, LLC, Tracey has achieved a strong customer collaboration to secure customer commitment to efficient provider enrollment/credentialing and the use of our products to get to a very efficient process.

Tracey’s career is comprised of over fifteen years management experience and over ten years project management execution while being recognized by staff for exceptional customer focus and employee recognition opportunity as “One of our Best” nominated by employees and leaders.

Tracey has dedicated her adult career to health care organizations experiencing process failure and been a part of achieving process success, execution successful implementation of training and process change, and leaves a mark as a leader by example.

Tracey holds a Master’s in Business Administration and Project Management and donates time and dollars to help children play sports who otherwise cannot afford it.    She also has a passion for the outdoors while spending time with family and on her Harley.  Tracey lives in Minnesota hence being outdoors is a love and a must.  Even in the cold!!!

Amy M. Niehaus
MBA, CPMSM, CPCSCredentialing, Enrollment and Medical Staff Services Consultant

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.