Delegated Credentialing: Tactics to Speed Enrollment & Payments


You can eliminate payer plan enrollment delays, get paid faster, and avoid re-enrollment disasters as long as your mid-sized practice is set up to perform delegated credentialing.

Payers want to hand off provider credentialing and re-credentialing to you, but you must have specific processes in place to qualify. Delegated credentialing provides you with 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 delegated credentialing status for your practice. This is where credentialing expert Tammy West MHA/ED, CPMSM, CPCS can help. During her 60-minute online training, Tammy will walk you through how to set up your own delegated credentialing program and provide you with proven strategies to manage it seamlessly and successfully.

Here are just a few of the step-by-step delegated credentialing setup and maintenance strategies you’ll receive by attending this 60-minute online training:

  • Pin down payer delegated credentialing contract clauses
  • Determine which NCQA rules you need to implement to comply
  • Reduce time to conduct primary source verifications
  • Pinpoint who to include in your credentialing committee and what they really do
  • Master what constitutes 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 general “how to” provider credentialing session. Instead, this training will walk you through exactly how to set up and maintain delegated credentialing at your practice. Attendees must have a good understanding of credentialing activities to gain the biggest benefit from this online training event.

Implementing a successful delegated credentialing program doesn’t have to be a headache. With a little help, you can take control over your payer activation dates, your new providers get enrolled sooner, re-enrollment is managed more accurately, and your claim payments stop getting delayed for credentialing problems. Don’t wait, Sign up today!

Meet Your Expert

Tammy West
MHA/ED, CPMSM, CPCSDirector, Hardenbergh Group

Tammy West  is Director, Professional Services for The Hardenbergh Group. She brings  25 years of experience in healthcare administration and 15 years in Medical Staff Services. Tammy specializes in CVO operations, provider credentialing, provider enrollment, quality analysis, quality improvement, quality auditing, delegation audits, and policy and procedure creation and implementation. She has extensive experience with CMS, TJC and NCQA requirements for provider credentialing and medical staff services.

Tammy leverages her vast professional experience to identify and place experienced, qualified MSPs to help clients fill temporary vacancies, supplement existing staff during peak workloads, assess and improve operational efficiency, prepare for regulatory surveys and audits, pursue NCQA accreditation and certification, and more.

Prior to joining The Hardenbergh Group, Tammy was a consultant and independent contractor assisting hospitals, health systems, CVOs, locum companies and private practices across the United States. She has extensive experience as an MSP, including credentialing specialist, provider enrollment specialist, medical staff coordinator, Medical Staff Manager, and CVO Director.

Tammy was a CVO Manager where she was responsible for creating and implementing policies and procedures for a new corporate CVO. During her tenure,  the CVO achieved NCQA accreditation and delegated credentialing status with commercial payors. Additionally,  Tammy worked as a quality auditor for an NCQA certified managed care company and an Adjunct Instructor teaching medical office systems classes.

Tammy has a BS in Human Services Management and a master’s in healthcare administration with a minor in Education. She is a member of the North Carolina Association Medical Staff Services and the National Association Medical Staff Services.


The presenter was incredibly knowledgeable.
Jennifer Connell