Course Description

The University of Florida Provider Credentialing and Privileging Program is an immersive and interactive six-module educational program designed to serve as a broad competency based educational experience.

The program is designed for professionals with responsibility and accountability for review and coordination of the credentialing and/or re-credentialing and privileging process for clinical providers (i.e. psychologists, nurse practitioners, physician assistants, physicians, chiropractors).

The program is asynchronous, allowing participants to start and stop the program based around the individual’s schedule. Educational modules not only provide a broad oversight of government and commercial insurer regulations and requirements, but also provide participants with a ‘tool-kit’ of up-to-date resources for use beyond the program.

Learner Outcomes

  • Define what credentialing is and its crucial role and impact on healthcare delivery
  • Identify staff responsibilities for credentialing different types of patient care providers
  • Understand the 'why' behind credentialing tasks and processes at healthcare organizations
  • Understand and be familiar with resources such as: NPI, National Provider Identifier, and its significance in the credentialing process.
  • Discuss CMS (Centers for Medicare and Medicaid Services) and PECOS (Provider Enrollment Chain and Ownership System) as related to the credentialing process.
  • Identify and familiarize yourself with the items (applications/documents/resources) necessary to successfully complete a credentialing application.
  • Understand the critical importance of accuracy and completeness regarding credentialing application management.
  • Review credentialing processes and understand the relationship between the credentialing process and interactions with MCO / Insurance Payers.
  • Identify the differences in credentialing for an MCO / Payer and credentialing and privileging in a hospital setting.
  • Identify and understand each step in credentialing a new provider to a medical group practice.
  • Identify the additional criteria required to credential a new provider who is working alone (solo).
  • Differentiate the credentialing process between a new solo provider and an established provider.
  • Understand the follow-up steps, and identify why re-credentialing and reappointment processes are periodically performed.
  • Review and discuss the managed care organization / payer re-credentialing process.
  • Review and Identify the differences in provider 'credentialing' and the hospital 'reappointment' process.
Enroll Now - Select a section to enroll in
Section Title
Healthcare Staff Credentialing and Privileging
Start Now, you have 90 days to complete this course once enrolled.
Course Fee(s)
Registration fee non-credit $349.00
Drop Request Deadline
Transfer Request Deadline
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