Streamline Provider Onboarding: A Guide to Flawless Credentialing and Enrollment

The process of credentialing new physicians and non-physician practitioners is a critical step for any practice. Even minor oversights can lead to substantial reimbursement delays, application rejections, and disruptions to patient care. To ensure your new providers can see patients and generate revenue without interruption, it is essential to navigate the complex web of documentation, payer-specific rules, and application procedures accurately from the start.

This session, led by expert Cati Harris, CBCS, provides a comprehensive walkthrough of the entire credentialing lifecycle. You will gain practical insights into assembling flawless application packages, managing key databases like CAQH and PECOS, and implementing effective tracking systems. Learn how to optimize your onboarding workflow to accelerate the billing process and secure timely reimbursements.

Key Learning Objectives:

• Timing and Initiation: Determine the optimal time to begin the credentialing process for a new provider.

• Database Management: Master the setup, maintenance, and attestation processes for CAQH and PECOS.

• Documentation: Identify the essential documents required for a complete credentialing package.

• Application Proficiency: Learn how to accurately complete and submit payer-specific credentialing applications.

• Payer Protocols: Understand unique requirements, contacts, and submission channels for different payers.

• Tracking and Verification: Implement systems to monitor application status, track documentation, and verify authenticity.

• Efficiency Strategies: Discover tips to streamline your credentialing process, identify flagged applications, and understand common processing timelines.

• Post-Approval Steps: Execute necessary actions once payer approval is received, including reviewing fee schedules and contracts.

• Effective Communication: Develop best practices for communicating updates between the practice, provider, and payers.

Agenda Highlights:

• The Pillars of Successful Credentialing:

  • Research & Preparation

  • Tracking & Communication

• Initiating the Process:

  • Conducting provider and payer research

  • The provider welcome packet and obtaining essential logins

• Document Preparation:

  • Managing key systems: NPPES, CAQH, PECOS, and Identity & Access Management

  • Compiling payer-specific documentation

• Application Execution:

  • Preparing and submitting applications via email, fax, and payer portals

  • Linking providers within payer networks

• Ongoing Management:

  • Handling provider re-validations and terminations

  • Systems for tracking documents and application status

• Minimizing Financial Impact:

  • Steps to take once credentialing is approved

  • Secure information storage and contract review

Who Should Attend?

This session is ideal for professionals involved in the provider onboarding and revenue cycle process, including:

• Credentialing & Enrollment Specialists, Experts, and Leaders

• Practice Managers, Owners, and Office Managers

• Healthcare Administrative, Billing, and Claims Teams

• Clinic Managers and Clinical Directors

• Revenue Cycle and Operations Staff

• Allied Health and Advanced Practice Providers

• Staff supporting NPI, NPPES, and CAQH

• Professionals holding certifications such as CPMSM, CPCS, and PESC

Presenter Biography:

Cati Harris, CBCS, is a nationally certified credentialing, billing, and coding specialist with over two decades of experience in the healthcare industry. As the Director of Provider Credentialing and Contracting at Solor Inc., she oversees full-service revenue cycle management for physicians across all specialties. Cati is highly skilled in managing large-scale credentialing operations, developing successful enrollment programs, and negotiating contracts and fee schedules with major payers.