Provider Credentialing 101 for Your Practice

Provider Enrollment and Credentialing
Expert: Tracey Tokheim Length: 90 minutes
Clear

The consequences of incorrect provider enrollment and credentialing are extreme. Your provider can be terminated from payer networks, lose hospital admitting privileges, and see dramatic reductions in new patients and revenue.

Provider enrollment and credentialing is complex and time consuming. Each payer can have slightly different requirements, which can easily trip you up and lead to serious backlash.

However, with a firm handle on the basics, you can avoid delayed payments due to credentialing and enrollment errors and ensure that your revenue keeps flowing.

That’s where credentialing and enrollment expert, Tracey Tokheim, can help. During her 90-minute online training session, focusing on provider credentialing 101 best practices, she’ll walk you through the most important aspects of provider credentialing and enrollment, and help you ensure everything sails through the approval process the first time.

Provider Credentialing 101: Everything Your Practice Needs

Here are just of a few of the enrollment and credentialing strategies you’ll receive by attending this provider credentialing 101 upcoming online training:

  • If providers are enrolled in CAQH and PECOS, do they also have to enroll with individual payers?
  • Is certification required for office staff doing credentialing?
  • What is the best way to confirm an enrollment submission?
  • How do enrollment requirements differ for non-physician provider (NPP) and physicians?
  • How to enroll effectively in CAQH?
  • What are the best software programs for tracking credentialing and enrollment?
  • What are the positives and negatives of hiring an outside company to manage credentialing?
  • What is the best way to check the status of an application?
  • Can new medical graduates be credentialed without being board certified?
  • Are both PECOS and CAQH enrollments necessary?
  • What is the best way to credential a newly licensed NPP?
  • Must we enroll NPPs if they bill incident to?
  • Should a practice, owned by a hospital, bill under the hospital or physician NPI?
  • What is the best way to get Matrix Information?
  • How should physician and NPP gaps in employment longer than 6 months be handled?
  • For telehealth services, must the provider on the other end be credentialed as well?
  • And so much more…

Provider Enrollment and Credentialing Services 

Unlike hospitals that have entire departments dedicated to credentialing, you’re probably being expected to tackle these duties on top of your already crazy day-to-day duties. You are not alone.

By attending this provider credentialing 101 interactive online training, you’ll get the inside scoop on how to file more accurate applications and avoid delayed or lost reimbursement due to preventable credentialing errors.

Don’t submit another application or credentialing update without signing up for this must-attend training. Register today!

Meet Your Expert

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!!!

Reviews

It was helpful to have a clear idea of how to set up the credentialing for our employees and contractors and suggestions were appreciated on tracking.
Lori O'Leary
CEO/ Clinical Supervisor, O'Leary Counseling, LLC
Great Webinar! I've been credentialing for just over a year and enjoy it. Your webinar was exactly what I needed.
Lorraine Levering
Provider Enrollment Specialist, Samaritan Healthcare
The webinar covered the process. It gave organizational tips
Tina Harkey
State Director of Admin Services, RHA Health Services
The webinar provided good reference material.
Bridgette Holmes
Business Office Manager, Eastport Health Care
I liked the data management suggestions.
Esther Mendoza
Credentialing Specialist, Biltmore Ear Nose and Throat