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Evaluation ViewAttendees 1

Credentialing/Privileging

The Great Debate: Insurance Plan v. Hospital Credentialing

Tuesday, October 1, 2024
1:15 PM – 2:15 PM MST
Location: Mile High Ballroom 1 -2
CE: 1
Interactive Session
Tomorrow's MSP® Skillsets: Relationship Building, Managed Care, Performance Improvement, Flexibility/Adaptability, Quality Review/Quality
Session Description: There has always been a long time rivalry between a health plan's credentialing/enrollment and hospital/group credentialing/enrollment. Understanding what each other has to do to comply with NCQA, State and Federal Regulations is very challenging. I thought that maybe putting the subject in a debate fashion would bring the 2 worlds together and have a little fun while we learn about each others process. The hope is that we find some commonalities, have some empathy to the differences and maybe start conversations about how we move forward to make it easier.

Learning Objectives:

  • Upon completion, a participant will be able to understand insurance plan requirements and how to ensure success.
  • Upon completion, a participant will be able to understand how working together can help maintain quality providers and member/patients safety.
  • Upon completion, a participant will learn how to avoid common pitfalls from the provider enrollment and insurance plan credentialing perspectives.