Insurance Credentialing Seminar & Workshop

February 23, 2019
Seminar: 9 a.m. – noon
Workshop: 1 – 4:30 p.m.

Please note the seminar and workshop are separate events. If you would like to attend both, please register for each event separately.

Insurance Credentialing Seminar

9 a.m. – noon

Register for the Seminar

This seminar will help give you all the tools to obtain an NPI, find an OPCA and understand what materials a practitioner needs to finish the OPCA. You will also learn about deciding the best commercial insurers for you. You will leave with an understanding of the whole credentialing process, rules of top insurers, the difference between Medicaid open card and CCO’s, learn the reason for obtaining a CAQH ID and more.

After this workshop, participants will need access to a fax machine as some insurers only accept via fax.

Attendees of this workshop will be able to:

Create a hospital admit plan

  • Obtain a NPI (if needed)
  • Find and complete an OPCA
  • Determine which commercial insurers you wish to credential and contract with, and designate as PCP or Specialist
  • Complete and save an OPCA without signature and date for future use
  • Send a completed OPCA and additional required documentation to start credentialing
  • Find OHP paperwork required to credential
  • Create a hospital admit plan
  • Obtain a NPI (if needed)
  • Create a web portal application for OneHealthPort.com (as needed)
  • Register for CAQH ProView

Seminar lead by Julia Puckett

Insurance Credentialing Workshop

1 – 4:30 p.m.

Register for the Workshop

This is your opportunity to have direct assistance in completing the Oregon Practitioner Credentialing Application (OPCA). This 20 page form contains the application, professional liability action detail and glossary of terms and acronyms needed to credential and pre-credential practitioners in the state of Oregon. It is the universal application for health plans and hospitals in Oregon.

Participants in this workshop must have:

  • State Professional License(s)
  • DEA Certificate or CSR Certificate (if planning to prescribe controlled substances that are within the scope of practice and listed on the formulary compendium.)
  • ECFMG (if applicable)
  • Face Sheet of Professional Liability Policy or Certificate
  • W9 or CP575 IRS tax documentation

These items should be on a laptop that the participant will bring to the workshop. The laptop and accompanying documentation will be used to complete an OPCA and register for CAQH Pro-view and online health portals. It is essential to bring a list of the top 3-5 insurers you want to credential with.

Outcomes

At the end of the workshop participants will:

  • Send a completed OPCA and additional required documentation to start credentialing
  • Create a web portal application for OneHealthPort.com (as needed)
  • Register for CAQH ProView

Presenter Bio

Julia Puckett has worked in the medical field for over ten years, with the last 6 years in administration. Over the years, Julia has gained experience in several medical practices serving a wide range of functions from front desk duties to back office and administration. Julia’s primary focus today is to verify that the credentials of health care professionals are in compliance with state and federal standards, and processes re-credentialing paperwork while maintaining a database of practitioners’ training, education, licensing, and experience information. This experience has allowed her to develop strong relationships with many insurance companies.