Transcription of NAMSS Managed Care Resource Toolkit V2
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NAMSS Managed Care Resource Toolkit V2
Managed care Resource Toolkit . AUGUST 2016. Table of Contents Summary ..2. Roadmap to Leadership Success in Managed care ..3. Managed care Credentialing Metrics .. 4-5. Managed care Tool to Credentialing and Primary Source Verification .. 6-9. Practitioner Verify Verify Board Certification .. 6-7. Verify Education and Training ..7. Verify Work Verify Hospital Privileges .. 7-8. Verify Malpractice ..8. Verify NPDB ..8. Query Sanctions ..8. Re-Credentialing ..8. Mid-Cycles ..9. Credentialing Job Descriptions .. 10-15. Managed care and Provider Enrollment Terms .. 16-19. Managed care Resources .. 20. Medicare 21. 1. SUMMARY. Disclaimer The resources and templates contained in this Resource are not endorsed by any accreditation organization. Users of this Toolkit should refer to the appropriate accreditation standards, local and federal regulations, and facility policies for any specific guidance. This Toolkit is simply a set of guidelines to assist those using it in creating their own tools.
3 ROAD MAP TO LEADERSHIP SUCCESS IN MANAGED CARE Taking a leadership role can be a daunting task. Handling new roles and responsibilities coupled with
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