Master Provider Credentialing Monitoring Requirements


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 that are designated as credentialing delegates. But where do you begin? How can you effectively monitor multiple providers? What specifically do you need to document? What actions are you required to take should an issue be identified?

You can more easily comply with some help from expert, Amy M. Niehaus, MBA, CPMSM, CPCS. This 60-minute online training, will help you monitor your provider incidents more easily, effectively, and accurately protect you from the serious consequences of regulatory and/or accreditation noncompliance.

Here are just some of the credentialing monitoring compliance questions you’ll get answered when you join Amy for this hour-long essential training:

  • What CMS, TJC, and NCQA monitoring requirements must you comply with?
    You’ll cut through the confusion, and more easily avoid non-compliance.
  • How often must you check your provider information?
    You’ll avoid missing important deadlines by using proven tools.
  • What online sources can you use to help make identifying issues easier and faster?
    You’ll learn about easy-to use sources that help you avoid fines or other corrective action.
  • What data must you document to comply?
    You’ll be able to document your monitoring activities for full-practice compliance.
  • What action must you take should a provider issue be identified?
    You’ll know exactly what to do to protect your providers and practice.

If you are responsible for provider credentialing, this seminar is for you. But, the longer you wait to take control of your monitoring, the more serious the consequences can be.

Don’t put credentialing on the back burner and risk significant fines, revenue losses or legal action.

Sign up now for this must-attend online training and take the first step to taking control of your credentialing processes and compliance.

IMPORTANT: Access to this seminar is limited so that all participants have an opportunity to get their specific questions answered by credentialing expert, Amy M. Niehaus.

Don’t delay, sign up online today!

Meet Your Expert

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.


Preprinted handouts were very helpful.
Connie Cooper
Administrative Support, EyeCare Associates of Texas, PA
The speaker was very good, along with the handouts and sample tools available in advance. Good Job!
Erin Hooks
Manager, Provider Quality Operations, BCBSAZ
Very Informative.
Michael Snell
CAO, Eye Surgeons Associates
I liked the outlined material and the useful links/question and answer period.
Kimberly Trentham
Billing Office Manager, Ear, Nose & Throat Consultants of East Tennessee
I liked that I had the slides and I really appreciate the resources shared. It was Great!
Michelle Valdez
Director of HR, Family Health Centers of Baltimore