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Credentialing is one of the most important processes to start and expand the medical practice. We will review the basics of the credentialing - what it is and why medical practices are required to go through the credentialing process to be in-network with payers. We will review the difference between in and out-of-network participations.

During this webinar we will learn how to prepare for submitting applications, what information you would need for new entities, new office locations and new providers. We will review the most common commercial payer credentialing steps, as well as CMS portals for a successful Medicare application submission. We will review how and when to follow up with specific payers.

Credentialing is a tedious and a complicated process, but it is very doable, when you surround yourself with the right resources and get educated on how to properly approach this process.

Learning Objectives/Agenda

• Understand what the credentialing process is
• Understand the difference between in and out-of-network participation
• Review the timelines for follow up on applications
• Briefly review CMS applications processes
• Briefly review the most common commercial applications processes

Why is this topic important?

Understanding credentialing processes, timelines and guidelines will help many providers, future practice owners and their management teams to plan and prepare better for when to open the new entities, when to expand into new office locations, when to hire new medical providers to streamline patient care and improve cashflow.

Who would benefit from this topic?

• Practice owners
• Practice administrators
• Credentialing specialists
• Billing specialists
• Billing managers
• Compliance administrators

What is the presenter's background/expertise on this topic?

Kate has over two decades of revenue cycle management experience in the healthcare industry. She is an expert at uncovering and correcting all billing and credentialing inefficiencies and errors, while streamlining operations to achieve maximum results. Kate’s successes include small and large practices, ranging from primary care to specialists and surgeons. Kate’s acute attention to detail, deep understanding of coding, billing, credentialing and proactive approach, make her an indispensable asset with all her clients.

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