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Mastering the Art of Insurance Credentialing
Introduction
Meet Your Instructor Coach Tiff! (1:43)
Overview of Insurance Credentialing
Importance of Insurance Credentialing in Healthcare
Target Audience and Course Objectives
Understanding Insurance Plans
Understanding Insurance Plans Module Overview (0:51)
Overview of HMO Plans
Overview of PPO Plans
Key Differences between HMO and PPO Plans
Impact of Insurance Plans on Credentialing
Credentialing Process
Credentialing Process Module Overview (1:04)
Steps in the Credentialing Process
Necessary Documentation and Information
Common Challenges in Credentialing
Strategies for Streamlining the Credentialing Process
Medicare and Medicaid Credentialing
Medicare and Medicaid Credentialing Module Overview (1:07)
Criteria for Medicare Credentialing
Criteria for Medicaid Credentialing
Navigating the Application Process for Medicare and Medicaid
Maintaining Compliance with Medicare and Medicaid Requirements
Advanced Credentialing Concepts
Advanced Credentialing Concepts Module Overview (0:50)
Hospital Affiliation Requirements for HMO Plans
Credentialing Out-of-Network Providers
IPA - Independent Practice Association
Best Practices in Credentialing
Tools and Technology for Credentialing
Tools and Technology for Credentialing Module Overview (1:14)
Benefits of Using Technological Tools in Credentialing
Evaluating and Selecting the Right Technology
The Art of Balancing Technology with a Human Touch
Compliance and Regulations
Compliance and Regulations Module Overview (0:56)
Ensuring Compliance with Regulatory Standards
Beware of "Cross-Billing"
Strategies for Staying Updated with Industry Changes
Conclusion
Lesson Conclusion| Final Thoughts
Next Steps in Mastering Insurance Credentialing
Bonus Supplemental Information!
Teach online with
Best Practices in Credentialing
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