About this Learning Activity

Credentialing 201: Accreditation Standards for CRPN

NCQA Credentialing Accreditation evaluates the operations of organizations providing full-scope credentialing services, which includes verifying practitioner credentials and credentialing/recredentialing committee review of practitioners. This online course dives into the standards for Credentialing Accreditation or "CRA" Standards. NCQA faculty and surveyors guide participants in addressing critical performance implications for credentialing practices. The course includes examples and lessons learned to help participants define, plan, and achieve excellence in credentialing. 

What You Will Learn

Content Topics 

• Core Standards for CRPN
• Internal Quality Improvement Process
• Agreement and Collaboration with Clients
• Protecting Credentialing Information
• Credentialing Policies and Committee
• Recredentialing Cycle Length
• Ongoing Monitoring
• Notification to Authorities and Practitioner Appeal Rights
• Assessment of Organizational Providers

Learning Objectives 

By participating within this learning activity, learners will:

• Describe updates and changes to the standards and guidelines
• Interpret the intent of Credentialing requirements
• Recognize requirement implications and considerations for stakeholders
• Define performance improvement opportunities

Learning Outcomes 

After completing this course, learners will be able to:

• Develop and maintain evidence-based program policies and procedures
• Prioritize performance improvement initiatives
• Implement reliable and valid practices for managing NCQA Accreditation                                                                                                                                                                  

Who Should Attend

• Clinicians, directors, managers, specialists, and coordinators who contribute to credentialing activities
• Credentialing consultants, contractors, delegates, and vendors
• Professionals in compliance or risk management
• Professionals in quality assurance/improvement or performance measurement

Faculty

Albert “Irv” Koehler, RN, MBA

Irv Koehler is a health care quality consultant for the Koehler Quality Group, LLC. In this position, he is an NCQA administrative surveyor and provides consulting services to organizations evaluating and preparing for NCQA Accreditation/ Certification projects, risk adjustment validation for managed care organizations, education on quality improvement practices and outcome measure development and tracking. Mr. Koehler is also a registered nurse with active licensure in Florida and Tennessee, and certification in quality and medical coding. Previously, he was a quality improvement professional at AmeriHealth Caritas and BlueCross BlueShield of Tennessee. Mr. Koehler has an MBA from the Florida Institute of Technology, a BS in Nursing from Florida Southern College, a BA in Psychology and an ADN from Purdue University.

Continuing Education

This course grants 2 Other Continuing Education Unit (CEU) points for PCMH Certified Content Experts.

This is a non AMA PRA Category 1 Credit TM, ANA CNE, ACPE activity.

* Please note – You must attend the entire program to be eligible for total number of contact hours.

Disclosure of Relevant Financial Relationships

The National Committee for Quality Assurance (NCQA) endorses the Standards of the Accreditation Council for Continuing Medical Education which specify that sponsors of continuing medical education activities and presenters at and planners for these activities disclose any relevant financial relationships either party might have with commercial companies whose products or services are discussed in educational presentations.

For sponsors, relevant financial relationships include large research grants, institutional agreements for joint initiatives, substantial gifts, or other relationships that benefit the institution.  For presenters or planning committee members, relevant financial relationships include the receipt of research grants from a commercial company, consultancies, honoraria, travel, or other benefits, or having a self-managed equity interest in a company; or having an immediate family member or partner with such a relationship.

Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation.

Relevant financial relationships exist with the following companies/organizations:

Faculty:

Albert “Irv” Koehler: None

Additional Planning Committee Members:
Vince Pereira: None
Julie Pung: None 
Tandeece Tubolino: None

This program was developed in part by NCQA staff.