Medicare Advantage: Provider Networks

<p>This course examines provider networks and the tools associated with their development. It includes an in-depth look at tools that are used in the development and validation of provider networks, critical terms used by the Centers for Medicare and Medicaid Services (CMS), and the usefulness of template contracts and checklists, and credentialing and verification requirements. Topics in this course include: Provider Contracting, MAO Responsibilities, Network Adequacy, <span>&nbsp;</span>Qualification and Selection, and Credentialing Facilities. After completing this course, learners will be able to recognize CMS’ requirements for MA plans to provide adequate provider networks.</p>

After this course learners will be able to recognize tools that may be used to develop and validate provider networks. recognize the usefulness of template contracts and checklists. recognize the requirements for provider qualification and selection. recognize the importance of access and availability of healthcare services. identify how medicare advantage organizations (maos) ensure that sufficient providers are available and how maos ensure continuity and coordination of care.