Скачать или смотреть 2025 Provider Credentialing Guide - Avoiding AI-Driven Denials and Enrollment

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In 2025, provider credentialing is no longer a background administrative task—it’s a frontline battleground affecting payments, compliance, and the very survival of healthcare organizations.

Compounding the issue is the rapid adoption of Artificial Intelligence (AI) by major insurance companies. AI is now being used not only to audit provider charts and claims but also to proactively assess “risk scores” that can trigger silent credentialing denials, delays, or even removals from networks. These AI-driven decisions often happen without notice, without peer review, and without any opportunity for correction or escalation. For providers and credentialing professionals, this shift marks a dangerous turning point, where being accurate and compliant is not enough if you're also not aware of what data insurers are tracking.

This webinar will examine the latest trends and challenges in provider credentialing and enrollment.

Learning Objectives:-

Identify current trends and policy changes impacting provider credentialing, including Medicare enrollment delays, payer denials, and extended application timelines.
Recognize the risks associated with credentialing delays, including billing disruptions, non-payment, audit exposure, and provider compliance violations.
Understand how insurance companies are using AI to automate audits, assess provider risk, and make credentialing decisions without direct communication.
Implement strategies to manage credentialing barriers, such as unreachable payers, missing escalation channels, and outsourced customer service models.
Use documentation and tracking tools to monitor credentialing progress, support appeals, and defend against denials or payer inaction.
Develop workflows that align billing, credentialing, and compliance teams to minimize payment risks and improve internal efficiency.
Apply best practices to monetize credentialing services and scale them as a revenue-generating function within a billing or MSO business.
Prepare for the future of credentialing oversight, including peer review triggers, audit trends, and payer AI profiling that may impact network participation.

Areas Covered:-

Enrollment & Credentialing Delays
Contract Denials & Communication Breakdowns
Billing & Reimbursement Risks
Provider Compliance & Peer Review Challenges
AI-Driven Credentialing Controls
Proactive Strategies & Tools.

Credentialing and enrollment are no longer routine back-office tasks — in 2025, they’re the frontline of provider survival.

In this fast-paced and urgent session, we explore the most pressing challenges affecting provider enrollment and credentialing today. From Medicare’s shifting requirements and application timelines that stretch months past expected deadlines, to payer denials with no clear reasoning, the enrollment process is becoming a serious threat to provider revenue and network participation.

This webinar will equip you with:

The latest trends and policy shifts impacting provider credentialing in 2025
How enrollment delays are tied to claim denials and payment disruptions
Strategies to manage peer review requests, credentialing audits, and contract rejections
Real-world examples of payer behavior shaped by AI algorithms
What providers, billing teams, and compliance officers must do now to protect network participation
Proactive tools for tracking applications, handling escalations, and documenting payer inaction
Whether you’re a credentialing specialist, billing manager, or healthcare executive, this webinar will help you stay ahead of the chaos.

Why Should You Attend?

A clear understanding of how enrollment issues directly impact reimbursement and audits
Tools to track applications and escalate unresolved cases
Strategies for dealing with peer reviews, pre-payment flags, and silent denials
Insight into how AI is reshaping credentialing risk — and what data insurers are watching
Actionable steps to protect your practice’s participation and cash flow.

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