TRCN Managed Care Credentialing 101

A Beginner's Guide to Managed Care Credentialing | taught by Dilsa Bailey

Course description

Welcome to TRCN-Training's course - Managed Care Credentialing 101. This course is a refreshing way for your new employees or managers new to the credentialing field to learn how to credential in a managed care organization.

This course covers a host of topics that help the new individual understand every aspect of the credentialing process. The following key items are reviewed from the perspective of someone who is brand new to the credentialing field, especially managed care:

  • What to look for and what you should find in your own organization's policies and procedures. The importance of starting there first.
  • What accrediting and regulatory agencies expect you to collect and verify when credentialing practitioners.
  • What accrediting and regulatory agencies expect you to collect and verify during the credentialing of organizations.
  • How to perform delegation oversight effectively.

This is a great course. If you want your new staff to perform effectively on the job as soon as possible, give them this tool. In my 20 years of experience as a credentialing manager, I have come to realize when the staff understands what they are doing and why, they are less likely to make costly and time-consuming mistakes. And on the plus side, they become more invested and enthusiastic about their careers.

This course begins with a comprehensive look at policies and procedures. It's available, right now, at an introductory price of only $99. This price covers the entire course, including soon-to-be-released modules for credentialing practitioners, organizations, and delegates. As the additional modules are released, the price will continuously increase. So ORDER NOW at this great value today. You won't be sorry.

You will have lifetime access to the entire course. The modules are released in segments, so you or your staff can review specific items at any time without having to view the whole course to find what you are looking for. Not only that, each segment is accompanied by a recap in a .pdf format and a quick quiz. At the end of each module will also be a comprehensive exam that will require a passing grade before going to the next. How about that for proof of education for your staff?

In applicable cases, additional resource information will be provided, so you won't have to look any further than at the bottom of your screen.

Order this amazing course today, get your staff started. Each segment is less than 10 minutes long. That is short enough to give your staff time to learn and move on during the course of their day. It's a fantastic learning experience.

Dilsa Bailey
Dilsa Bailey
Consultant and Trainer

THE RIGHT CREDENTIALS NETWORK, LLC

Dilsa S. Bailey, CPMSM is a Medical Services and Credentialing Consultant and Trainer. Her experience in hospital, medical services, and managed care credentialing spans over twenty years. Her expertise in these fields have helped her employers and clients meet and maintain accreditation as well as the regulatory requirements for Joint Commission, NCQA, URAC, CARF, CMS, and various states. In addition to ensuring compliance and managing departments to a level of excellence, Dilsa has sat on both sides of the auditing table for delegation oversight.

Dilsa shares her knowledge regularly with peers through one on one coaching, webinars, and presentations for related professional organizations. Her training experience has included presentations at the 2009 National Association of Medical Staff Services Conference, the 2013 Annual Tennessee Association of Medical Staff Services Conference, and numerous presentations at quarterly Georgia Association of Medical Staff Services meetings. She has lead and facilitated educational seminars for her employers and clients. Her quest to empower credentialing professionals is evident in her creation of the popular Managed Care Credentialing Group on LinkedIn and her most recent book, “A Comprehensive Guide to Finding the Right Doctor: Tips from a Healthcare Credentialing Expert.”

Dilsa continuously maintains knowledge of the credentialing world and its effectiveness in the delivery of quality patient care. In that spirit, she has established long-term working relationships with talented and dedicated professionals across the healthcare organizational spectrum.

Dilsa S. Bailey, CPMSM - TRCN Instructor

info@therightcredentials.com

Course Curriculum

Managed Care Credentialing 101 (MCC101) - INTRO
05:55
MCC101 - INTRO FREE PREVIEW
MCC101 Intro Recap FREE PREVIEW
MCC101 Intro Quiz FREE PREVIEW
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MCC101 - Policies and Procedures (PnP)
41:16
PnP Intro
MCC101 PnP Policy
MCC101-PnP Policy Recap
MCC101 - PnP Policy Quiz
MCC101 Pnp Regulations
MCC101 PnP Regulations Recap
MCC101 PnP Regulations Quiz
Medicare Managed Care Manual Chapter Six - Relationships with Providers
42 CFR 438.214 - Provider Selection
MCC101 PnP Who and How to Credential
MCC101 PnP WhoHow Recap
MCC101 - PnP Who and How to Credential Quiz
MCC101 PnP Rights
MCC101 PnP Rights Recap
MCC101 PnP Rights Quiz
MCC101 PnP Decisions
MCC101 PnP Decisions Recap
MCC101 PnP Decisions Quiz
MCC101 PnP Recredentialing
MCC101 PnP Recredentialing Recap
MCC101 PnP Recredentialing Quiz
MCC101 PnP Monitoring
MCC101 PnP Monitoring Recap
CMS Medicaid Program Integrity-Social Security Administration Death Master File
MCC101 PnP Monitoring Quiz
MCC101 Pnp Organizations
MCC101 PnP Organizations Recap
MCC101 PnP Organizations Quiz
MCC101 PnP Delegation
MCC101 PnP Delegations Recap
MCC101 PnP Delegation Quiz
MCC101 PNP FINAL QUIZ
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MCC101 - Practitioner Credentialing (PC)
49:24
MCC101 Practitioner Credentialing Intro
MCC101 Practitioner Credentialing Intro - Recap
MCC101 Practitioner Cred Type
MCC101 Practitioner Cred Type Recap
MCC101 Practitioner Credentialing Type Quiz
MCC101 Practitioner Cred Application
MCC101 Practitioner Cred Application Recap
MCC101 Practitioner Cred Application Quiz
MCC101 Practitioner Credentialing Criteria
MCC101 Practitioner Credentialing Criteria - Recap
MCC101-Practitioner Crededentialing Verifications
MCC101Practitioners Credentialing Verifications-Recap
RESOURCES-MCC101
MCC101 Practitioner Credentialing - Criteria and Verifications
MCC101 Practitioner Office Site Visits
MCC101-Practitioners Office Visit Recap
FYI - Office Site Visit Update
MCC101-Practitioner Final Decision
MCC101-Practitioners Final Decision Recap
MCC101-Practiioner Rights
MCC101-Practitioners Rights-Recap
MCC101 PractitionerOngoingMonitoring
MCC101-Practitioners Ongoing Monitoring Recap
MCC101 Pract Performance Monitoring
MCC101-Practitioners Performance Monitoring Recap
MCC101 Pract Recredentialing
MCC101-Practitioners Recredentialing Recap
MCC101 Practitioner Credentialing Quiz - FINAL
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MCC101 Organizational Credentialing (OC)
10:15
MCC101-Organizations Intro
MCC101-Organizations Intro Recap
MCC101 Organizations Type
MCC101-Organizations Type Recap
MCC101-Organization Criteria
MCC101-Organization Criteria - Recap
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MCC101 Delegation Oversight (DO)
17:40
MCC101 Delegation Intro
MCC101-Delegation Intro Recap
MCC101-Delegation Agreement
MCC101-Delegation Agreement
MCC101-DelegationSurveys
MCC101-Delegation Surveys
MCC101-Delegation Oversight
MCC101-DelegationOversight
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FINAL QUIZ
FINAL QUIZ
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Reviews (2)

Response to course - The material was very informative

by Leonard Williams
This is a great course. The structure and content were good. The test questions were mostly fair and clear, as well as, I was able to find the answers in the material.

Really helpful for beginners to really understand the process!

by Heather Green
plus you have PDFs of everything discussed to further review later!

Response to course - The material was very informative

by Leonard Williams
This is a great course. The structure and content were good. The test questions were mostly fair and clear, as well as, I was able to find the answers in the material.

Really helpful for beginners to really understand the process!

by Heather Green
plus you have PDFs of everything discussed to further review later!