Introduction

ConCred- Credentialing Department users

ConCred addresses the complete Contracts & Credentialing life-cycle management along with Correspondence & timeline tracking. It enables the organizations to stay on top of their contracts with payors and helps in maintaining the required Credentials to meet the standard of service and not fail any audits or violate any terms. 

It eliminates the unorganized tracking of providers and their compliance needs for various payors and helps in having a complete handle on the capacity definition and forecasting. 

Scope and Purpose

This document is for the users of the credentialing module to track and maintain the compliance requirements of the providers. It walks them through the features relevant to their scope of work within ConCred. 

Process Overview

System prompts you what is required by the organization from the providers for the locations you are responsible for. Managers can send you new Enrollment requests or request you to add a new location for any provider through ConCred. You will also see the alerts and notifications for the data relevant to providers, so that you can take necessary action. 

Typical tasks to be done by the credentialing manager/team will include-

• Reviewing the alerts on the dashboard
• New enrollments (through PDF applications, online applications, rosters)
• Inform payors about new service locations for providers
• Verify compliance items added by the providers