The emergence of blockchain technology has affected many industries and credentialing is no exception. This innovative method for storing data with unmatched integrity and consistency makes it uniquely suited for improving traditional credentials verification methods. We talk with Tiffany Long, Director of Credentialing for BlocHealth, a company on the forefront of integrating blockchain technology in healthcare. We’ll discuss how blockchain works and, more importantly, the advantages for using it in the verification process and credentials management overall. Tiffany’s years of experience in the credentialing field allow her to explain this new technology in a way those of us in the credentialing field can understand and relate to. Change is coming and it’s likely blockchain will play a pivotal role in the years to come.

Credentialing Collaboration Group Podcast

Is Blockchain the Future of Credentialing?

Our 2018 holiday card poem:‘Twas the final month of another great year,Just a few more weeks and 2019 will be here.We’re so excited to see what it will bring,More than likely, it’ll be more credentialing.We’re dreaming of snow-filled holiday vacations,While completing payer enrollment applications.While you’re searching for more gifts to buy,We’re wondering about updates to your NPI.And while you decide which sweater to wear,We’re contemplating the future of Obamacare.We’re lamenting Aetna’s purchase by CVS,Because their last merger was a complete mess.We love what we do, even with all the steps,Notwithstanding a few Grinch-like network reps.As we reflect back on this year and all it brought,We just wanted to share this quick thought.We hope your holidays and this coming year,Are full of happiness, prosperity and cheer.

PRO TIP: Handling the Holidays

No matter which side of the credentialing industry you work on, there is bound to be conflict. Whether it be from your supervisors, physicians, clients or colleagues, the complex and high stress world of credentialing will inevitably cause friction. All too often, our own instincts make the problem worse as our attempts to defend ourself and assign blame just make a bad situation worse. 

PRO TIP: Avoiding the "Blame Game"

Few in the medical profession are unfamiliar with CAQH but how many of you know how it started, the various platforms it offers and how the data you enter is used? Ron Urwongse, Senior Product Manager, joins us to discuss these topics and more. Ron offers some tips on working with the CAQH ProView system and discusses various ways CAQH is working to improve their platforms. 

CAQH: A Conversation

New changes that went into effect on 10/1/18 could affect your workflow process when submitting online enrollment applications using PECOS. Plus some “do’s and don’ts” when working with enrollment analysts. For more information on this latest change, CLICK HERE to view a recent CMS training bulletin.

Copy of PRO TIP: Medicare PECOS Enrollment Changes

Keeping track of managed care contracts, understanding reimbursement rates and knowing when to renegotiate your contracts is a challenge for any practice. Host Rob Arturi talks with Dana Bellefountaine, president and CEO of CodeToolz, a contract analysis tool that simplifies all aspects of maintaining managed care contracts. We explore the challenges associated with tracking renewal and renegotiation terms as well as the importance of making sure your reimbursements are in line with your payer contracts. Dana shares his insight after spending more than two decades in the healthcare industry and how his product, the CodeToolz Contract Analyzer, can simplify the data and put what you need to know right at your fingertips. Plus – Dana has a special offer exclusively for CCG members. To learn more about CodeToolz, visit www.codetoolz.com or call (877) 464-3005 to speak with a CodeToolz representative.   

Inside Look: CodeToolz Contract Analyzer

A few proven strategies for dealing with customer service representatives in the credentialing field. We discuss how a few simple changes in approach can save time, reduce stress and lead to better results for you and your providers.

PRO TIP: Better Results from Customer Service

Starting any business means facing challenges and starting a professional services business is no exception. Host Rob Arturi talks with Attorney Ben Webster, of the Morgan & Morgan Business Trial Group, about key legal considerations for starting or operating your business. We discuss different corporate structures, such as starting and LLC or an S-Corp, as well as the legal advantages of forming a corporate entity. We discuss important aspects of formal operating agreements as well as structuring legally sound client agreements that are easy to understand and enforce, should the need for litigation arise. Ben shares with our audience some of the common mistakes made when drafting business contracts and how to avoid them. We also discuss what steps every business owner should take if they are considering filing a lawsuit or have been sued by another party. The Business Trial Group provides unique, contingency fee based legal services for business related disputes throughout the country. To learn more about how the Business Trial Group can help your business, visit www.BusinessTrialGroup.com or www.forthepeople.com.

Legal Considerations for Your Credentialing Business

Sara Krakowski owns and operates Healthcare Revenue Solutions, a healthcare consulting firm where she assists practices and facilities with contract analysis and reimbursement rate negotiation. Sara shares with our listeners some key tips on the contracting process and common mistakes to avoid when you are requesting a new contract or renegotiating an existing contract. We discuss an array of issues relating to payer fee schedules, contract terms, closed panels and practice options that maximize reimbursement rates. If you are interested in working directly with Sara, contact her at Krakowski.HRS@gmail.com.

Expert Advice on Payer Contract Negotiation

Host Rob Arturi talks with industry experts on various topics in the world of credentialing.

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Credentialing Collaboration Group Podcast

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