If you want to keep your medical practice’s revenue flowing, your provider’s CAQH profile must be in compliance and up to date. You must accurately implement the mandatory New CAQH changes to get your enrollment approved and payor reimbursement flowing in. During enrollment and credentialing processes both government and commercial payers use your CAQH profile. Complying with the 2024 changes is also vital to ensure you comply with the No Surprises Act requirements related to current and accurate provider directory listings. Failure to do so can result in heavy penalties violation (i.e., each incorrect directory listing).

This session will review a step by step each and every section in CAQH. Credentialing and enrollment specialists are to comply with all the implemented CAQH updates to avoid negative revenue impacts. Implement a solid process for maintaining your CAQH provider accounts and understand how to partner with your practitioners to be fully compliant and structured. Review attestation requirements to speed your re-credentialing turnaround time and create an internal process to easily track CAQH attestations and maintenance.

Learning Objectives:

• Know how you should implement the new CAQH updates
• Identify if new CAQH Profile/Module implementation is necessary for your medical practices or not
• Pinpoint the data fields & profile sections that will improve your enrollment process
• Review the CAQH process connection to the billing claims submission & reimbursements
• Know the new rules and guidelines for CAQH
• Know how to maintain your CAQH provider accounts compliantly
• Review attestation requirements to speed your re-credentialing turnaround time

Areas Covered in the Session:

• CAQH
  • What are New Changes for 2024?
  • What is Next Step?
  • What to Expect?
  • How to Advocate?
• CAQH PROVIEW
• Provider Profile
• CAQH Practice Manager
• Organization Profiles
• CAQH Proview for Groups
• Validate Locations for Errors and Suggested Changes
• Limit TIN to One for Existing Practice Locations Currently
• Streamlined Credentialing Process
• Demographic and Professional Provider data Administration Processes
• Real-time System Validation
• Provider Specialties
• Healthcare Organizations using CAQH
• Avoid Application Delays
• Impact the CAQH Accounts have on Your Revenue Cycle
• Required Professional Documentation
• Getting Started with CAQH Credentialing Portal
• Initial CAQH Credentialing Requirement
  • Types of Information
  • Required Steps
  • Proper Materials
  • Manages Information for Multiple Provider
• Complete Process for Creating CAQH Account
• Provider Data Portal
  • Profile Data
  • Personal Information
  • Professional IDS
  • Professional License
  • DEA Registration
  • CDS
  • Medicare
  • Medicaid
  • ECFMG
  • USMLE
• Education and Professional Training
• Specialties
• Practice Location
• Hospital Affiliations
• Credentialing Contacts
• Professional Liability Insurance
  • Insurance Coverage
  • Current Insurance Policies
  • Federal Tort Claims Act (FTCA) Coverage
• Employment Information
• Professional Information
• Disclosure
• Documents
• Authorization Setting
• Live Q&A Session

Attendees:

• Credentialing Specialist
• Revenue Cycle Managers
• Enrollment Specialist
• Hospitals
• Mental Health Providers
• LCPC
• LMFT
• Practice, Clinic Owners
• Hospital Leadership
• Authorized Officials
• Delegated Officials
• Revenue Cycle Directors
• Credentialing
• Office Manager
• Revenue Cycle
• Operations
• Billing Team
• In and Out of Network Providers
• Medical Billing Companies
• Providers Office Staff
• Physician
• Hospitals and Facilities
• Insurance Companies
• Healthcare Attorneys
• Executive and Administrators
• Front Desk
• Scheduling
• Authorizations Staff
• Medical Assistants
• Certified Nursing Assistants