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Webinars

Delegated Credentialing and Facility Credentialing

Thursday, June 27, 2024
1:00 PM - 2:30 PM (EDT)

Hosted on Zoom

Event Details

Abstract

This informative webinar will help you gain a comprehensive understanding of Delegated Credentialing and Facility Credentialing processes in the healthcare industry for applied behavior analysis (ABA) provider organizations. Delve into the intricacies of these essential procedures and discover how they impact healthcare organizations' ability to work effectively with payors.

The speakers will guide you through the nuances and requirements associated with these credentialing methods, ensuring you leave with valuable insights and knowledge.

Learning Objectives

  1. Delegated Credentialing: Understand the concept's significance in healthcare, especially for large health systems. Learn how it extends beyond credential verification and empowers healthcare entities to make vital decisions on behalf of payors, impacting provider organization eligibility.
  2. Navigate Delegation Agreements & Compliance: Explore the role of delegation agreements in Delegated Credentialing and their alignment with NCQA, URAC, CMS, and legal regulations. Understand the elements of these agreements, whether standalone or amendments, and grasp the roles of the Delegated Entity, Delegate, and Client. Recognize the impact of regulatory compliance on Delegated Credentialing success.
  3. Master Facility Credentialing: Dive into the intricacies of Facility Credentialing, which are crucial for healthcare facilities to join health plan networks. Learn specific requirements, like the minimum number of BCBAs, and how to efficiently add clinicians while meeting payor standards. Gain insights into periodic payor audits, ensuring compliance and understanding their implications for facility operations.

BACB CEU is not offered for this webinar

Cost

  • CASP Members - free
  • non-members - $20

Presenters

Michele Beal, CPMA, CMRS

Michele has focused her career on ABA Therapy billing and insurance funding sources, founding ABAB and MKS Consulting, nationally recognized Autism Services revenue cycle, consulting and auditing companies, supporting the provider just starting out through the large ABA agency flourishing with multiple providers, clients, and funding sources. Michele merged her company with Rethink Behavioral Health in early 2023, where she now serves as the VP of RCM - Quality.

As a CPMA and CMRS, she can provide risk assessments to support revenue cycle compliance. With tighter regulations on healthcare services, providers need to know when they are at risk for non-compliance and remain out of harm's way of fraudulent activity. Her goal is to help providers find that peace of mind.

Sarah Schmitz, CMRS-I, CPB, CPC

Sarah has over two decades of experience in medical billing and coding. Following her son’s autism diagnosis, Sarah dedicated her expertise to learning as much as possible about available treatments. Recognizing a need for advocacy in a growing industry, she turned her love of the revenue cycle into a growing company as the Founder and President of Comprehensive Billing Consultants, the company quickly growing into a nationally recognized organization specializing in billing, consulting, and credentialing. Her work at CBC has assisted hundreds of providers in starting their practices, aiding in establishing care in home, clinical, and residential program settings. To further expand upon this mission, she has also created an Autism Billing Bootcamp to provide education to providers, spoken at many ABA workshops, and co-authored a book covering the revenue cycle. 

In 2005, she served as the local chapter president of the APPC. Since then, she has become a CASP Business Affiliate and, as of 2022, serves on the Standards Committee for the Autism Commission on Quality (ACQ). She is committed to ensuring that patients receive the highest standards of care and alleviating the administrative burden on providers. Her steadfast commitment to patients and providers extends not just to herself but also to her team, striving to make the field more accessible to those who need it.