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Healthcare

Payer Enrollment vs Delegated Credentialing - Which Option is Best for Your Organization

Recorded Webinar
Presented by - Tammy West
Tammy West
Description:

Payor enrollment is a time-consuming process that creates barriers to practitioner onboarding and revenue generation. Payor enrollment can delay the onboarding process for months, especially with commercial payors. These delays create issues with provider satisfaction, patient satisfaction, revenue generation, access to care and, ultimately, patient safety. However, enrollment with health plans is essential for revenue generation.

Delegated credentialing offers many benefits for an organization, such as increased revenue generation, shortened turnaround times for onboarding, and increased provider satisfaction, to name a few. If you’ve considered delegated credentialing but are not sure if it’s the best option for your organization, this presentation is for you! The webinar will discuss the differences, advantages and disadvantages between payor enrollment and delegated credentialing and the effect of each on revenue cycle. It will review the timelines for enrollment with payer enrollment and delegated credentialing and provide a side by side analysis of the turnaround times for both. Lastly, the webinar will educate the audience on how to determine the feasibility of delegated credentialing and deciding which option is best for your organization.

Areas Covered:-

  • Define revenue cycle, payor enrollment, and delegated credentialing
  • Explain the difference between payor enrollment and delegated credentialing
  • Discuss the impact of payor enrollment and delegated credentialing on revenue cycle
  • Review average turnaround times for delegated credentialing and payor enrollment
  • Review NCQA guidelines for delegated credentialing
  • Discuss the importance of software in delegated credentialing
  • Determine the feasibility of delegated credentialing for your organization.

Who Should Attend:-

  • Payer Enrollment Specialists
  • Revenue Cycle Managers
  • Credentialing Specialists
  • Credentialing Managers
  • Payer Enrollment Managers
  • Practice Administrators
  • Practice Managers
  • Billing Personnel.

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Meet Your Expert
Tammy West
Tammy West

Tammy is the Senior Director of CVO Operations and Regulatory Compliance with The Hardenbergh Group. She brings 25 years of experience in healthcare administration and 18 years in Medical Staff Services. She specializes in CVO operations, provider credentialing, provider enrollment, quality analysis, quality improvement, quality auditing, delegation audits, and policy and procedure creation and implementation. She has extensive experience with CMS, TJC, and NCQA requirements for provider credentialing and medical staff services.

Tammy leverages her vast professional experience to help clients assess and improve operational efficiency, prepare for regulatory surveys and audits, pursue NCQA accreditation and certification, and more.

Tammy has a master’s in healthcare administration with a minor in Education and a BS in Human Services Management. She is a member of the North Carolina Association Medical Staff Services and the National Association of Medical Staff Services.

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