Management, Consulting, Training, and Delegation Oversight
If you answer yes to any of these questions, you may need my help.
Have you assumed responsibility for managing credentialing and provider data and don't know where to start? To ensure the department runs smoothly, you need to know the little details that can cause delays or failures.
Are you a new health plan or IPA and just realized how daunting the administrative requirements of credentialing can be? Let me help you streamline and build an effective credentialing program.
Are you preparing for accreditation or certification? Let's get you prepared and set-up for ongoing maintenance. You will pass with flying colors.
Do you need a coach or does your staff need one? Sometimes, you need to talk through the credentialing problem to find a resolution. Or, maybe you just need a sound operational manual or clear-cut policies and procedures. Let us create one specific to your organization.
Does your staff need their training reinforced? Training can be customized to meet their needs.
Do you have staff new to the credentialing profession and/or accreditation requirements? Consider our online courses.
Are you falling behind on your enrollments? Your providers need to get paid and maybe you should be considering delegation arrangements.
What about delegation oversight? Do you need assistance performing surveys to ensure your delegates are compliant?
Are you interested in becoming a delegate for a payor? Let's make sure you are ready to pass their audits with flying colors.
Building a new credentialing program/department
Analyzing an existing credentialing program
Creating or revising policies and procedures, operational manuals, documents
Preparing a credentialing program for accreditation surveys
Analyzing organizational readiness for delegation arrangements and audits
Auditing files for performance improvement and/or regulatory compliance
Type of training:
One on One Coaching
Topics include, but aren't limited to:
Provider Data Management
Represents payors to conduct pre-delegation and annual delegation audits.
Audits documents that include:
Policies and Procedures
Ongoing Monitoring Logs
Credentialing Committee Minutes
CMS Compliance Training
Hearing and Appeals Processes
Audits initial and recredentialing files per NCQA, CMS, and state regulatory requirements.
Whatever is specific to the payors' needs, we will audit for compliance and provide objective final reports with recommendations.