CONTEXT / SCOPE

The purpose of this SOP is to provide the CSM with clear instructions and steps to ensure full understanding of the Credentialing Software and its respective modules and submodules. Having this knowledge will improve how CSMs provide their training sessions, as well as be more prepared for questions the admins will have. 

IMPACTED TEAMS

• Strategic CSMs

• Core CSMs

GLOSSARY

• ASC - Ambulatory Surgery Center

• Board Certification - The process by which a physician or other professional demonstrates a mastery of advanced knowledge and skills through written, oral, practical, or simulator-based testing.

• CAQH - Council for Affordable Quality Healthcare

• CAQH ProView - The CAQH Provider Data Portal is the healthcare industry's premier resource for reporting professional and practice information to health plans and other healthcare organizations.

• CRED SOFT - Self-Managed Credentialing Software (Credentialing Software)

• CSM – Customer Success Manager 

• DEA - Drug Enforcement Administration

• EIN - Employer Identification Number.

• Exclusions - The result of an extreme sanction which is issued by the HHS OIG (Office of Inspector General). Exclusions are typically reserved for those who pose a high risk to patients or a program’s integrity.

• FQHC - Federally Qualified Health Center

• NPDB - National Practitioner Data Bank

• NPI - National Provider Identifier

• NUCC- National Uniform Claim Committee

• OIG - Office of Inspector General

• Payor (aka “Payer”) - A person, organization, or entity that pays for the care services administered by a healthcare provider.

• Provider - A person or entity that provides medical care or treatment.

• SAM - System of Award Management

• SF - Salesforce

• TIN - Taxpayer Identification Number.

• TL - Team Lead

TABLE OF CONTENTS

There is an Add Information button at the bottom of the page:

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Before the Training Session

Admin LMS Account Set-Up

1. Make sure that you have uploaded the completed Locations, Departments and Positions rosters into the system (these will be requested since your first email using the Welcome to MedTrainer! CSM Template available in Outreach). After that,

2. Ensure to send the admin the downloaded Employee roster from their account’s Employee Center. (this will be required in the Onboarding Call Recap email template) Once that is completed by the admin, you will be able to upload their employee lists with less issues.

3. Please make sure to send the following rosters to the admin:

   • https://docs.google.com/spreadsheets/d/1P6Xjx5rrZt_ytsQ44TirOfj6TXi0V_yr/edit?usp=drive_link&ouid=110045133522799162123&rtpof=true&sd=true

   • https://docs.google.com/spreadsheets/d/1Y2L2KZF0bib6tEmIacQnIlL_ftV2uJGN/edit?usp=sharing&ouid=110045133522799162123&rtpof=true&sd=true

   • ONLY for Standard and Premium Accounts

3. Remember to enter the “LMS Set-Up Completed Date” field in the Onboarding Object.

Your Demo Account Set-Up

The purpose of this is to:

• Ensure you are is familiar with the system, performing all the possible tasks in each module.

• Showing the admin how the system looks real time, with populated data.

• Leaving the admin’s account as a clean slate to use from scratch.

Make sure to have:

• Providers and Practices Locations with Credentialing Enabled

• Uploaded test documents for at least one provider

• Enrollments, Verifications, Mandatory and Location Documents in at least one Practice Location.

Preparing the Meeting

If your admin would like you to schedule the meeting on a specific date and time, review Options 1, 2 and 3 sections of the Onboarding SOP. -

• Option 1: Outreach Platform

• Option 2: Outreach Everywhere Extension

• Option 3: Google Calendar

If the admin hasn’t scheduled a training session yet, please send proposed times as shown in the Option 4: Gmail (Inserting Proposed Times) section of the Onboarding SOP.

For all the above, please make sure to select the correct meeting type when scheduling. You can find them in the Training Meeting Types Outreach Collection. Remember that we have the following:

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Please note that the meeting descriptions will contain the schedule per training session, as stated in the Training Matrix (found in the https://medtrainer.atlassian.net/wiki/pages/resumedraft.action?draftId=4221435905&draftShareId=7263dcfd-160f-46aa-bf09-123b3825a5ef)

We need to have the training sessions logged into the corresponding SF account, and confirm that the meeting also appears scheduled in Gong so that it can be recorded. You can check in Gong if your meeting appears once you click on the “View upcoming calls” section. It should appear if the process was followed. If this is not the case, please perform the following steps:

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Organization Management Training

If this is the first training session with your admin, provide Organization Management training covering the following topics (it is suggested to follow the steps on the https://medtrainer.atlassian.net/wiki/spaces/CSKB/pages/4154654777 ,  as it follows the recommended setup order. Feel free to forward this file to your admins as well):

• Locations

  • How to create and modify them

  • How to designate a location manager

  • Open

    

• Departments

  • How to create and modify them

  • Department Visibility

  • Open

    

• Positions

  • Both position databases (extended and generic)

  • How to create and modify them

  • Open

    

• Employee Center

  • Creating new users

  • Changing employee status

  • 6 options under each user dropdown

  • Open

    

  • Full profile walkthrough

    • Open

      

  • Settings:

  • Organization Reports:

    • Open

      

• For accounts that purchased an integration: When the admins try to create employees manually from the employee center, they will see the warning message that remarks the risk of duplicated accounts or incorrect assignments. We want to encourage them to add the new employees only by the integration and to understand the possible consequences of doing manual creation. please refer to the https://medtrainer.atlassian.net/wiki/spaces/CSKB/pages/4159505060 SOP for more information.

PART 1: The Organization Management Module

Preparation

Before creating any employees it is best practice to have the account foundation ready to make the rest of the organizational management process more efficient.

Practice Locations

The first step is to create the practice locations. As a recommendation, if the needed locations are less than 10, it is faster to individually create them. If there are several locations, it is faster to download our CSV template, populate the information, and then upload the file so they can be created in bulk.

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Once you create the location, you will have the option of enabling credentialing

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You can also do this with an already created location

Credentialing Information. This is where the admin will be able to set up their practice location details.

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Please give the admin a walkthrough of the tabs:

Information

Populating the modules of the Information tab will be helpful not only for better organization, but for a more complete location profile at the time of starting enrollments with payors:

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Set Up Insurances

Payors/Insurances that pertain to each practice location can be set here:

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Providers

Once providers start getting enabled in each location, and get their provider profiles active, they will start showing below as such:

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This is one of two was of enabling providers.

Verifications

Set verifications for any applicable documents, such as the DEA License Verification.

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Mandatory Documents

“Document needs vary based on the type of provider and insurance plan.  Here are a list of base documents that may be needed:

1. Practitioner License(s)

2. Malpractice Insurance (Certificate of Insurance)

3. DEA (federal) and state CDS certificates

4. Board Certification(s)

5. Diploma – copy of highest level of education (required for non-MD’s,DO’s)

6. Current CV (showing current employer, and all entries have mm/yy format)

7. IRS Form W-9

8. Current driver’s license

Other documents that may be applicable:

1. ECFMG Certificate (if educated outside of The United States)

2. Passport or other citizenship documents (if born outside U.S. and not previously enrolled in Medicare)

3. Collaborative Agreement (required for Nurse Practitioners)

4. Admitting Arrangement letter (required for providers who do not have hospital admitting privileges)

5. Prescribing arrangement letter for providers not holding DEA certificate”

To learn more about documents providers need for credentialing, visit Types of Documentation Needed for Physician Credentialing.

Here, admins can set a list of documents that will be requested from providers:

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Location Documents

“Documents needed for your legal entity:

1. IRS form CP575 or replacement letter 147C (verification of EIN)

2. CLIA Certificate

3. Business License

4. Copy of office lease (required for therapy facilities)

5. Letter of bank account verification (for Medicare enrollment)”

To learn more about documents providers need for credentialing, visit Types of Documentation Needed for Physician Credentialing.

All practice location documents can be set here:

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Make sure to guide your admin through these action buttons:

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What you can change in the edit button are the document properties, not the document itself.

 

OPTIONAL STEP FOR ADMINS:

To set up Location Managers in advance (or if they haven’t been set up previously), go back to Organization Management - Locations, find the location you need, and click on this button:

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Here, you can add any of your Admins and Super Admins as Location Managers:

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You can also enable manager notifications

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Or delete admins

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Organizational NPIs

“A National Provider Identifier (NPI) is a 10-digit numerical unique identifier and a Health Insurance Portability and Accountability Act (HIPAA) standard.  NPI replaced the numerous different provider numbers previously issued by each payer with a single identifier that is used across all health plans.

 There are 2 different types of NPIs; Type 1 (individual) and Type 2 (organizational). All clinical providers need to obtain a type 1 (individual) NPI number.  This number will identify the provider who rendered services to a patient and needs to be reported on claim forms sent to payers.

 Group practices that bill with a group tax identification number (TIN) should also apply for a Type 2, organizational NPI.  This Type 2 NPI number should be used to complete enrollments with payers and for billing purposes.  For group practices, individual providers' NPIs will be linked to the group NPI in the payer's system and both reported on claim forms submitted for reimbursement.”

To learn more about NPIs and TINs, visit https://support.drchrono.com/hc/en-us/articles/7117152502427-Individual-vs-Organizational-NPIs

There are two types of NPIs: Type 1, for individual health care providers, such as dentists and hygienists, and Type 2 for incorporated businesses, such as group practices and clinics. In this submodule, the admin will be able to add their organizational NPIs (Type 2) and link them to the corresponding practice locations. 

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Here, admins can add as many Type 2 NPIs as they need/have. They are also able to edit, search and filter by location.

Departments

Guide the admin through the process of setting up their necessary departments and positions. 

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Positions

Remember that we have two databases: the initial 10-page database , and a hidden generic database after clicking on the “Create Position” button. Once the pop-up window shows, there are 3 options:

1. Searching through the Generic Database, selecting and hitting “Create”

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2. If they need something more specific (if there are any internal ways of classifying positions), they can click on “Create New”  and type in the position.

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3. If they have a similar case as #2, but they need to do a massive position upload, they can click on Upload CSV and upload the filled-in spreadsheet.

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Divisions

If  the organization has divisions, these can be added here:

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The Default Division cannot be edited nor deleted.

PART 2: The MT Credentialing Module

Visiting Individual Provider Profiles

Activating and Disabling Providers

In the Provider Profiles dashboard, the admin will be able to enable and disable provider profiles, as well as see any terminated provider profiles. Ideally, you should already have at least one active provider profile, which will be used for the walkthrough. 

If no providers have been activated previously, go to the “Not Enabled” tab, look for your provider, and click on “Activate”. Once you do, they will let you choose their main practice location. Then you can “Save” or “Save and go to profile”.

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Providers can also be disabled at any time:

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Practice Locations

Admins can add or remove locations as applicable. If the provider has one main practice location, the system will recognize it as such by having it dragged to the top of the list.

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Admins can also pull practice location reports per provider:

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Documents

This tab will help the admins monitor provider documents individually. Please provide the steps on:

• Filtering the document list view

• Uploading a new document

• Reviewing the action buttons

• Sending requests

• Reviewing reminders

• Exporting reports

Overview and Filters

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You can filter visibility by document type, status, expiration date, and if documents have been archived

Document Requests

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Setting up requests is much simpler, as this process has much more visibility (a “Requested” column and a Document Request dropdown menu)

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This is what the document request review looks like. Once the responsible uploads the documents, this visible items will change.

Creating Document Containers

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These containers will hold the documents requested from the providers. They help organize the workflow.

Document Action Buttons

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Review these action buttons with the admin.

Add file version

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View detail

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Delete document container

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Activity logs

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Cancel request

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Exporting Reports

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If the admin wishes to see a document report per provider, this is the way to obtain it.

Switching Profiles

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To quickly switch to a different profile, click on the two arrows button on the top right corner

Exclusions

“An exclusion is a provision within an insurance policy that eliminates coverage for certain acts, property, types of damage or locations. Things that are excluded are not covered by the plan, and excluded costs don’t count towards the plan’s total out-of-pocket maximum.“

To learn more, visit https://www.healthinsurance.org/glossary/exclusion/

The exclusions tab runs these automatically, so if there are any exclusions involving the provider, they will pop up here:

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There are 3 available filters: needs review, excluded and not excluded. The admins can also look into the Source status detail.

Verifications

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In the overview, you have several statuses to choose from. You can also add a new verification or export a report.

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Adding a new verification will take you to another page to fill in necessary fields and upload documentation. Keep in mind that, since we don’t have real provider examples, you will not be able to replicate these steps internally.

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Once new verifications are added, you will see these action buttons: verify, logs and delete.

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This is the view when clicking on the verify option. Keep in mind that, since we don’t have real provider examples, you will not be able to replicate these steps internally.

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If anyone has interacted with/made changes to the verification, the logs history will start populating automatically.

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Lastly, this is what happens when you delete a verification.

Information

This is where all provider background history is added. Think of this as a very detailed resume. Guide the admins through all the categories, and remember to mention:

• The progress bar will adjust to the amount of information completed.

• All fields highlighted in red are mandatory

• Billing type is pre-set and should remain as is, for this is configured according to initial account set-up found in the https://medtrainer.atlassian.net/wiki/spaces/CSKB/pages/4131422209SOP

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A lot of our clients use a platform called CAQH, where they have similar information fields filled in for their providers. In order to migrate the information into our platform, they will need the following:

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Once these requirements are completed, the button will become enabled.

To learn more about CAQH and how it is involved in the MedTrainer credentialing process, visit:

https://medtrainer.com/blog/caqh-credentialing/

 

Enrollments

“Provider enrollment is the process of registering with an insurance network to become an approved provider and receive reimbursement for services provided to patients covered by that network. It involves submitting an application and supporting documentation, such as proof of licensure, malpractice insurance, and education and training credentials.“

 

To learn more about enrollments, and how they are different from provider credentialing, please visit Provider Credentialing vs. Provider Enrollment: Understanding the Difference

This tab is designed to be complex, as there are many factors to consider during the Enrollment process.

Walk the admin through the following steps:

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You can filter visibility by insurance, workflow state and status. You can also view enrollment details individually.

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You can add a new enrollment process when clicking on the New Enrollment button.

When viewing the Enrollment Details, you will have these tabs available:

• Information - Main enrollment details, and additional information about the enrollment workflow, the provider, and the lines of business. There are also important timeline and date fields at the bottom.

“Line of business, in the realm of commercial insurance, refers to a specific category or type of insurance coverage that is offered to businesses or individuals within a particular industry or sector. It represents a distinct area of insurance that is tailored to address the unique risks and needs associated with a specific line of work or business activity.“

 

To learn more, visit Line of Business

• Process Checklist - The enrollment process to-do list. These lists can be set by provider or group enrollments.

• Notes - Important mentions and updates about the enrollment process.

• Tasks - Here is where items from the process checklist can be assigned to individuals

• Amend Form - Here is where admins can fill in provider initial application forms for any payers they have selected. Each payer has its own fillable form.

• Enrollment Documents - Any documents relevant to the provider’s/group’s enrollment process

• Contacts - Any applicable contact points discovered or needed throughout the enrollment process

• Fax - If any fax messages are received, they will appear here.

• Activity Logs - All in-system actions taken or changes made throughout the enrollment process will reflect here.

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You’ll notice that the enrollment details page is now stand-alone, and contains a summary of the enrollment main information at the top.

If any tasks are due, they will appear as shown below. Remember that admins can also run enrollment tasks reports:

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Dashboard

Lastly, the Dashboard tab provides us with a status summary on: Documents, Verifications, Enrollments and Enrollment Tasks. The graphs shown are also hyperlinked to each of their respective sections of the provider profile, for quick access.

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Company Settings Part 1

Admin Dashboard

This dashboard provides an overview on all credentialing stats (including Notifications and Tasks) and has two main action buttons: “+New Enrollments” and “Activate Providers”.

Please give the admin a full overview of what shows below:

• Notifications

• Tasks (new tasks can be created here)

• Documents (hyperlinked)

• Enrollment Status (hyperlinked)

• Verifications

• Licenses

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Admins can active providers directly from their dashboard, they will be redirected to the provider profiles dashboard.

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Provider Profiles Dashboard

In the Provider Profiles dashboard, the admin can:

• Disable active provider profiles

• Enable provider profiles

• View any terminated provider profiles

• Pull reports per active provider and all active providers

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Custom Provider Profiles

 Previously, the provider profile only supported a set of predefined fields. When enrollment rosters or credentialing forms required additional information, administrators had to manually maintain external Excel files or partially complete reports and manually fill in missing data.

 Clients are now able to:

• Capture all necessary provider details within the system

• Eliminate the need for manual, external roster updates

• Auto-fill credentialing forms with complete, accurate data

• Maintain more consistent, compliant provider records

• Scale their processes more efficiently as their organization grows

Here’s what’s new:
 

A new Custom Fields facility where administrators can:

• Create custom short text fields

• Automatically create Field IDs used for mapping forms.

• Manage field statuses (Active/Deprecated)

Provider profile integration:

• A new Custom Fields tab in every provider profile

• Custom fields automatically available across all providers

Reporting improvements:

• Custom field data will now be reportable within the system

• No more reliance on external spreadsheets for complete rosters

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https://support.medtrainer.com/home/mt-credentialing/provider-profile

Privileges and Appointments

“Hospital privileges give doctors authorization to practice at and admit patients to a particular hospital. These privileges allow physicians to perform specific procedures like surgery and must be awarded by every hospital where a doctor wants to practice in. 

Types of hospital privileges

There are three main categories of hospital privileges:

• Admitting privilege authorizes a physician to admit patients to a particular hospital without the need for the patient to go through the ER first. Physicians with admitting privileges are able to treat their patients within the hospital and work alongside hospital staff when need be. 

• Courtesy privilege authorizes a physician to admit, but not necessarily treat, patients at a specific hospital. Generally, courtesy privileges are used by physicians to visit admitted patients regarding their medical care.

• Surgical privilege authorizes physicians to perform outpatient surgeries and to book the hospital or surgery center’s operating room.”

Hospital privileges and hospital credentialing sound similar, but they are indeed two different processes. Hospital credentialing must happen before you apply for hospital privileges.

During this credentialing process, the medical facility will focus on ensuring that you are able to provide competent and safe patient care. To do so, hospital bylaws will be consulted and you will be required to provide proof of your education and medical training. “

 

To learn more about privilege appointments and reappointments, visit https://support.drchrono.com/hc/en-us/articles/7117152502427-Individual-vs-Organizational-NPIs

This dashboard shows an overview of all the existing privileges and appointments applicable to the providers. Admins and Super Admins will be able to generate new appointments here as well.

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Admins can create new appointments, and filter appointment list visibility.

Documents

This module shows an overview of all document stages, and will also let the admin upload any missing documents, or update any expired ones:

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Auto-Extract

This is a powerful new feature that enables users to automatically extract data from completed PDF forms and populate it directly into the system. It significantly reduces the time, effort, and risk of manual data entry for credentialing workflows.

What’s changing?
 With Auto-Extract, admins can simply upload a filled PDF to a provider's document container and use the Auto-Extract icon to pull data into the system automatically — using mapped field names.

What does this mean for our clients?
 Clients will now be able to:

• Eliminate repetitive manual entry from credentialing workflows

• Reduce human error in transferring data

• Speed up provider onboarding and application processing

• Keep provider information up-to-date with minimal effort

Features:

• Auto-Extract action icon in the Documents page of the credentialing section

• Automatically pulls data from mapped PDF fields into the system

• Works on any PDF form that

  • Is not password-protected

  • Is correctly form-mapped with MT field names  

  • The document container in which the file is stored is not archived, with status missing, or in a "request document" state.

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Remember there is an Expiring status available.

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Massive Update

Document Containers help admins organize documents further, by helping them categorize even more. This enhancement is designed to simplify and accelerate document management, addressing one of the most requested improvements from our clients.

• Massive update option: A new action is available in the Documents module (mt|credentialing / Documents), allowing users to select multiple document containers and initiate a massive update.

  • Massive editing capabilities: Users can update fields such as: Alias, state, Expiration Date (with a "Does not expire" option) and Archived.

  • Enhanced user interaction: A confirmation screen is provided to review and verify changes before applying them.

• Activity Logging: All changes made during massive updates are recorded for traceability.

• Improved selection tools: Select all visible items or the entire dataset, even across multiple pages, for massive updates.

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  Updates:

  • Renamed "Expiration Date" Column:

    • The "Expiration Date" column in the document table has been renamed to "Expiration" to reduce redundancy.

  • Simplified "Version" Column Display:

    • The "Version" column now displays only numeric values (e.g., "1," "2") instead of the full label (e.g., "Version 1," "Version 2").

  • Reordered Columns:

    • The "State" column has been repositioned to appear immediately after the "Archived" column for improved user navigation.

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  • You can edit effective dates & comments in bulk

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Editing Aliases

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Autofill

This enhancement simplifies field population by introducing auto filling capabilities that leverage provider data within the system. Users can now automate the autofill process, and ensure accurate data integration for every submission. This reduces time spent on manual tasks and minimizes errors, enabling a more efficient workflow.

With these updates, users can now autofill any document (that meet all requirements) to meet their diverse credentialing requirements, such as onboarding new providers, submitting reappointment applications, or completing enrollment packages. Whether managing a single provider or multiple, this streamlined process ensures higher accuracy, consistency, and compliance while saving valuable time.

What it consists of:

1. Mapping field names

   1. For this scope we are only supporting fields from provider information section.

   2. Details about the field names for mapping and how to configure can be found in the User Guide.

2. Autofill for Form Fill Documents

   1. One-click action to populate form-fill PDFs with mapped provider data.

   2. Seamless integration ensures new data replaces existing data on the most current document version—no new version is created.

3. Activity Logs

   1. Logs are generated only if data is updated during the autofill process.

   2. Users can view these logs to verify that autofill actions were recorded accurately.

PDF Forms

Our platform makes sure that manually entered data in PDF forms is retained, providing a more seamless and reliable experience for users.

Previously, when users manually entered data into PDF forms, the information was not retained if the page was refreshed or navigated away from. This meant that any manual changes were lost, requiring users to re-enter the data. Additionally, when combining the autofill feature with manual input, only the autofilled data was saved, while manually entered information was discarded. This created inefficiencies and frustration, especially in workflows requiring both autofill and manual data entry.

Here are the features:

1. "Save" Button for Manual Changes:

   • A "Save" button is available for editable PDF forms, allowing users to save manually entered data.

   • The button is only visible for PDF files with fillable fields.

2. Unsaved Changes Alerts:

   • Users will see a persistent alert when they manually enter data into a PDF form, reminding them to save their changes before leaving the page.

3. Unsaved Changes Modal:

   • If a user attempts to navigate away from the PDF viewer with unsaved changes, a modal will appear, offering options to save changes, or stay on the page.

4. Integration of Autofill and Manual Input:

   • The system retains both autofilled and manually entered data, allowing users to combine both methods without losing any information.

5. Activity Logs for Manual Saves:

   • Every time a user saves manually entered data, the system logs the action.

6. Exclusion of Signature Fields:

   • Fields marked as "signature type" are excluded from being saved automatically, ensuring the integrity of signed documents.

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Credentialing Packets

Previously, creating a credentialing packet was a manual and time-consuming process conducted outside MT. Users had to copy and paste all necessary documents into Adobe PDF to combine them into a single file.

This feature empowers Admins and Super Admins to seamlessly create credentialing packets for each provider directly within the system, eliminating the need for manual document assembly.

This enhancement enables Admins and Super Admins to create, manage, and optimize credentialing packet templates effortlessly.

Capabilities in Credentialing Packet Settings
Within this feature, users can:

1. Create New Templates: Set up credentialing packet templates by specifying the required document containers.

2. Edit Existing Templates: Update or modify templates to reflect new requirements.

3. Deprecate Templates: Retire templates that are no longer needed.

4. Delete Templates: Permanently remove unnecessary templates.

Using Credentialing Packet Templates in the Provider Profile/ Documents tab
A new option, Generate New Packet Version, is now available for credentialing packet containers. This feature allows users to:

1. Select an active template from the Credentialing Packet Settings.

2. Match the template’s document containers with the available document containers for a specific provider.

3. Choose which documents from the list should be included in the new version of the credentialing packet.

4. Automatically merge all selected documents into a single version, accessible within the Credentialing Packet container.

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Files Staging Area

This module allows the user to submit documents into provider profile in one place, making the provider documents upload/update process more streamlined. It has a similar functionality to the In-App reports. Please go over it with the admin.

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We support the following file types:

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Document Container Selector:

By implementing the Document Container Selector, we are addressing the issue of duplicate container creation and ensuring accurate versioning of documents.
With this improvement, admins can now easily select or create document containers while publishing a File, streamlining the process and making it more efficient.

Characteristics:

• Document Container Selector. Admins now can create or select a specific document container for publishing files, providing flexibility and control.

• Automatic Versioning. When publishing a file,  if the select document container already exists in the Document Tab a new version will be automatically created.

• File extension filtering.  Filters have been updated to display files based on their file extensions, making it easier to locate specific file types

Upload Link:

Previously, providers could not upload their own files. All submissions were manually collected and uploaded by admin or super admin users, creating extra work.
Implementing the Upload Link will reduce admin workload by automating file collection and minimizing manual processing.

This update introduces a self-service file upload option for providers and employees, reducing manual tasks for admins and making submissions faster.

Features:

• Upload Link Generation: Admins can create a unique, secure upload link for selected providers from the Staging Area.

• Direct Provider Uploads: Providers and employees can upload files directly using their personalized link—no admin upload needed.

• Ability to email upload links to provider: Providers and employees receive instant email for uploading their files - no extra login is required.

• Improved Tracking: Uploaded files are immediately available in the Staging Area for admin review.

AI Document Type Classification:

Clients can rely on AI to assist with the document type classification, reducing the risk of mislabeling and accelerating the onboarding and credentialing workflows.

Features:

• AI-Powered Document Classification: Uploaded documents are now automatically analyzed, and a document type is suggested using AI.

• User Validation Workflow: Admins and Super Admins can review AI suggestions and either confirm or override the predicted document type.

• Integration with Upload link: Integration with the existing Request Files and Upload Link workflows. Files submitted through secure links will also be analyzed by the AI for classification.

Enrollment Applications

Here, the admin will be able to filter and visualize all enrollment applications initiated, as well as: view details, delete or view activity logs.

• The View button leads to the Information section of the Enrollments tab of the corresponding provider profile.

• The New Enrollments button leads to creating any missing enrollment application records for providers

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Admins can also filter the enrollment application list visibility.

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Workflow states and statuses can be changed directly in this dashboard.

Credentialing Dashboards

This dashboard provides a summary on the following regarding enrollment applications:

• Open and Closed Enrollment Applications

• Top 5 Most Open and Closed Enrollment Applications

• Open and Closed Applications Age

• Top 5 Oldest and Slowest Cases

The goal is to give the admin full visibility of what is happening, as well as notice trends and outliers.

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Once enrollments start being submitted, these widgets will start populating information.

• An 'Enrollments productivity' entry has been added to the 'Credentialing dashboards' catalog.

• When accessing the new dashboard, an 'Enrollments turnaround time' section, with the following widgets included will be displayed:

  • Completed Applications Total Turnaround Time (TTT)

  • Open Applications Total Turnaround Age (TTA)

  • Submitted Applications Time to Submission (TTS)

  • Unsubmitted Applications Time to Submission Age (TTSA)

  • Payer Turnaround Time (PTAT)

  • Open Applications Payer Turnaround Age (PTAA)

• The 'About widget' functionality has been revamped to provide more detailed and useful information about the widget calculation to the user.

  • Each widget has its own description available.

• The filtering options has been enhanced.

Open

Two new widgets: ‘Follow-up Dates’ and ‘Document Status’.

With these new widgets, users can now:

• Track enrollment follow-ups—Determine whether a follow-up is ‘Expiring’ or ‘On Time’ (Follow-up Dates widget).

• Monitor document status—Identify if a document is ‘Expiring’ or ‘Active’ (Document Status widget). To enhance flexibility, we’ve added an ‘...are expiring within’ setting inside each widget, allowing users to define the number of days used to calculate the follow-up and document statuses inside the widgets.
  Additionally, to improve clarity and usability, we’ve enabled the ‘About Widget’ functionality, providing a detailed explanation of how each widget calculates statuses.

Updates:

• Follow-up Dates Widget → Available under Enrollments → Workflows folders.

• Document Status Widget → Available under Appointments/Privileging → Status folders.

• ‘...are expiring within’ setting added to both widgets.

• ‘About Widget’ modal enabled for better understanding.

Reminder: Please log out and log back in to see the changes.

Open

Credentialing overview dashboard

With this tool, users can:

• See a unified view of the providers' profile data, documents, CAQH profiles, exclusions, and enrollments.

• With a single glance, easily determine the full credentialing health of the company.

• Quickly identify "areas" of work that need focus.

• Visualize the amount of upcoming credentialing work so the user can plan ahead

   

What’s New?

• We are adding a new pre-configured dashboard and four new widgets.
  Widgets in the dashboard: All providers documents, Required provider documents, Verification documents, provider profile data, Exclusions, CAQH, Enrollments status, Enrollments follow up dates, and Enrollments recredentialing dates.

Open

Insurances

This module simply summarizes the list of Insurances linked to the account’s Practice Locations:

Open

Admins can be led to the total of enrollments by clicking on the Insurance Name, and then over to the enrollments dashboard.

Forms Catalog

This module gives the admin the power to build, customize, and manage form templates to use
during the different credentialing workflows in one centralized place, significantly increasing the
productivity of their business.

Who can access?
Super Admin and Admin users can create, edit, download, deprecate, and delete forms as they
require.

Open

Feature Release: Create File Versions from Forms Catalog
Now, admins can select forms directly from the Forms Catalog instead of manually uploading files. This reduces errors, saves time, and ensures compliance.

Here’s what’s new:

• Two version-creation options:

  • Upload File (existing method).

  • Select from Catalog (new!).

• Smart dropdown: Shows only active forms for the document type.

• Empty state guidance: If no forms exist, a link directs users to the Forms Catalog.

• Works across: Documents Facility, Provider Profiles, and Container Detail View.

• Upload PDF Forms:

  •  Admins can now upload custom PDF files (up to 125MB) directly to the Forms Catalog via a simple drag & drop pop-up.

  •  These forms appear in the table with a Creation Type of PDF.

  • Forms Catalog Module Renamed: The module formerly known as Custom Forms is now called Forms Catalog – more intuitive, easier to find.

  New Table Columns & Filters:

  •  Say hello to these new columns:  → Creation Type, Lifecycle, Description, Creation Date, and Last Update

  •  And goodbye to: Provider Category and Specialty are now filters only.

  Button Changes for Clarity:

  •  The old "New Form" button is now “Build New Form,” and a brand new "Upload Form" button has been added for PDF uploads.

  Where will these updates be visible?

  • mt|credentialing → Forms Catalog

  • Forms Catalog Table

  • Provider-facing document workflows (via Document Containers)

Important Note:The Forms Catalog currently supports DOP forms only, but soon you’ll be able to upload PDF forms and associate them with any document type.

Open

For more information, please consult the https://drive.google.com/file/d/1ZBoZxyagXdnCczv52WQWmbqOez6U_PR-/view

Business Entities

“In simplest terms, a business entity is an organization created by an individual or individuals to conduct business, engage in a trade or partake in similar activities. There are various types of business entities — sole proprietorship, partnership, LLC, corporation, etc. — and a business's entity type dictates both the structure of that organization and how that company is taxed.“

 

To learn more, visit https://www.nerdwallet.com/article/small-business/business-entity

This dashboard will let admins and super admins manage and create new business entities:

Open

Admins won’t only be able to create new business entities, but also set up all information for each one! Make sure to guide your admins through these features, as well as the filters available in the dashboard.

Locations

Though we mentioned this module in part 1, admins are able to do much more:

• Viewing location details here

• Filtering locations (by credentialing enabled/not enabled, and more)

• Create new locations

Open

• Multiple setup:

  • Adding multiple verifications

  • Adding multiple documents

  • Enabling insurances in multiple locations

Open

External Facilities

How was this handled in the past?
 Previously, only the Support team could manage external facilities. Companies had to rely on Support to add or edit facility information, limiting flexibility and responsiveness in managing appointments.What does this update mean for our clients?
 This release empowers company Super Admins to independently manage their facility catalog. It speeds up appointment setup, improves accuracy, and ensures that organizations can swiftly respond to changes—without bottlenecks.Here’s what’s new:

• Super Admins can create, edit, deactivate, and manage company-owned external facilities.

• New “External Facilities” module added to the mt|credentialing menu.

• Facility table includes search, filters (by state and status), and default sorting by most recent changes.

• Facilities created by Support remain available for selection but are read-only for companies.

• Deprecated facilities are hidden from use and can be reactivated as needed.

• Improved sorting behavior—recently created or updated entries appear first.

• Freeze columns in the appointments table and save your layout via Profile custom settings.

Open

Org NPIs

Here, admins can add and manage their Organizational NPIs

Open

Credentialing (In-App) Reports

These is the available reports we have:

Open

We currently have this color formatting feature:

Open

Pivot Table Functionality: a new functionality that provides users with the ability to explore the data for specific use cases in a summarized way. This is done by adding pivot columns and values. Guide the admin through an overview of what these look like, and how data is arranged.

• Access them under the section “Pivot data sets”

Open

• Explain that Pivot columns expand on the columns from just being fields to all the different values from a former field. 

• Explain that Pivot values are a specific value that can have a cell background color for easier and quicker visibility.

• Go over how Pivot filters work, and how they will only be affected by pivot values.

Reports, Settings and Company Settings

Reports

A couple of these reports are still active in several accounts, but remember that the main goal is to get our admins to migrate into the In-App reports fully.

Open

Settings

Simple changes like enabling email notifications, changing the company name and address, and updating the super admin’s password.

Open

Company Settings

These help our admins tailor out how they want their LMS accounts to work. Remember to go into module-specific settings here:

• Under General Settings:

  • Provider number

• Under Reminders:

  • Enable Provider Notifications (Credentialing)

• The Credentialing Tab

Open

PART 3: The Exclusions Module

This module basically provides quick detailed access to detailed exclusion-related information. The submodules are the following:

Individuals Matches

Any matches found for providers can be seen here:

Open

Individuals Default Settings

If the admins want to run exclusion checks for all staff (not providers only), they will be able to configure that here. They will also be able to set exclusions per credentialing (practice) locations:

Open

Individuals Current Settings

Admins will be able to configure specific exclusions per provider here:

Open

Notifications

This  submodule will simply help configure enrollment notifications:

Open

Exclusions (In-App) Reports

We will be retracing the steps on Credentialing (In-App) Reports section.

These is the available report we have here, but the admin is free to customize it:

Open

After the Training Sessions

A Recap for the Attendees

Once the training session has been completed, send a email using the Outreach Training Recap Outreach Email Template immediately after the training session recording has been processed (or at least before the end of day), and fill in necessary information such as:

• Participants

• Modules

• Pending Subjects

• Relevant Links

Our Customer Support Department

It is paramount to not only encourage, but reinforce the admin on the use of our Customer Support Department. Provide the contact information below:

• Email: support@medtrainer.com

• Phone number: 844.596.6553

• http://Support.medtrainer.com

• The Support Module in the MedTrainer platform.

Other Training Sessions

If the account acquired the Learning and/or the Credentialing Software Modules, please refer to any of the following SOPs:

• https://medtrainer.atlassian.net/wiki/spaces/CSKB/pages/4221468673

• https://medtrainer.atlassian.net/wiki/spaces/CSKB/pages/4221436306

Adoption: The Next Steps

Lastly, please refer to the https://medtrainer.atlassian.net/wiki/pages/resumedraft.action?draftId=4135616513&draftShareId=a3711c8d-3de8-4bf5-95fb-6db42e50e83c, in order to continue with the account adoption following the instructed guidelines.