Introduction

Delegated Credentialing–Providers Taking the Lead in Insurer Credentialing

September 3, 2019 - 1:00 pm to 2:00 pm (ET)

*
__________________________________________________________________________

Topic: Delegated Credentialing — Providers Taking the Lead
Topic: in Insurer Credentialing

Faculty: Charles Chulack and Joshua Hodges

__________________________________________________________________________

Time is Money…

The physician group practice affiliated with your hospital has been complaining about the inordinate amount of time it is taking to get its physicians enrolled as participating providers with health insurers. The group practice needs solutions and needs them fast. Every day the group’s practicing physicians are not enrolled, they are not being reimbursed for the services they provide. What can we do?
__________________________________________________________________________

Covered in this AC:

Preparing for delegated credentialing;
*
The policies and procedures required for delegated credentialing;
*
Requirements for Medicare and Medicaid managed care plans;
*
Satisfying insurer accreditation standards; and
*
Negotiating delegated credentialing agreements with insurers.

__________________________________________________________________________

Listen live on September 3, 2019. Or, purchase the recording (MP3 or CD) of this audio conference to share with medical staff members at an upcoming meeting or throughout the year.
__________________________________________________________________________

This audio conference is part of our 2019 Grand Rounds series. Order the entire series for just $1,850/line*. Click here for more information.

* Registration fee includes one phone line; you may add up to two additional lines to your order for $50 each line (per audio conference).

__________________________________________________________________________

Designed to be informative for any medical staff member, Grand Rounds 2019 should be particularly helpful for medical staff leadership: Medical Staff Officers, members of the Medical Executive Committee, Department Chairs, Chairs of the Credentials and Peer Review Committees, and the Chairs of other key medical staff committees.

If you have new members in any of these important positions, this is a not-to-be-missed opportunity for direct education that we guarantee will be helpful to them in their new roles.

Learning Objectives

Upon completion of this audio conference, participants should be able to:

Explain how credentialing for insurers is different from Medical Staff credentialing;
*
Summarize what policies and procedures you will need to perform credentialing for insurers and how they differ from your Medical Staff policies;
*
Describe the credentialing requirements for the Medicare and Medicaid programs;
*
Create an awareness of the insurer accreditation entities and their standards; and
*
Assess what should and shouldn’t be in delegated credentialing agreements with insurers.

Education Credit

Instructions on how to obtain your Continuing Education certificate for audio conferences will be e-mailed to the contact person for your organization at the conclusion of each audio conference.

Category 1 CME

Joint Provider Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Pittsburgh School of Medicine and HortySpringer Seminars. The University of Pittsburgh is an affirmative action, equal opportunity institution. The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CEUs Credit

Other health care professionals are awarded 0.1 continuing education units (CEUs), which is equal to 1 contact hour.

NAMSS Continuing Education Credit

This course has been approved for National Association of Medical Staff Services (NAMSS) continuing education credit and NAMSS hereby awards 1.0 NAMSS continuing education credits for participation in this activity. Accreditation of this educational content in no way implies endorsement or sponsorship by NAMSS.

HortySpringer Audio Conference Disclaimer

The information presented during an audio conference and any supplementary materials provided to registrants are intended for educational and informational purposes only. Nothing contained therein is to be considered as the rendering of legal advice for specific cases or circumstances.

No one should act or refrain from acting on the basis of any information presented during an audio conference without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer practicing as permitted by applicable laws, regulations or rules of professional conduct. No attorney-client relationship is formed by registration for an audio conference or the use of the supplementary materials.