Provider Management and Business Development School
Turn knowledge into systems: Credentialing Education for care, Business Education for growth.
Welcome to EduKonnekt
Welcome to a growing community of professionals in credentialing, committed to transforming Puerto Rico’s healthcare system from the inside out.
The Hidden Workforce, and Our Mission to Elevate it
It’s time to broaden who we call “healthcare providers”
Beyond white coats and exam rooms, there is a vital network of professionals—credentialing delegates, coordinators, compliance officers, billing teams, and administrative staff—who make care possible. They ensure providers can work, institutions can operate, and patients can access the services they need. Without them, nothing moves forward.
EduKonnekt is more than an education program; it’s a living, action-driven initiative that brings practical training, operational stability, and system-wide alignment to Puerto Rico’s healthcare sector. We close real gaps in professional development through structured learning, real-case problem solving, and tailored training aligned with Credentialing & Privileges in Puerto Rico (Law 73) and beyond.
The Domino Effect: Strengthening the system from within
Healthcare doesn’t begin at the moment of care—it starts with the operational professionals who make access possible. EduKonnekt supports roles that are essential yet often overlooked: credentialing delegates, coordinators, billing teams, insurance representatives, and administrative staff.
Their work keeps providers active, institutions compliant, and patients connected to uninterrupted care.
When the system fails, patients do too
When credentialing is delayed or mismanaged:
Providers face interruptions in income
Institutions experience financial losses
Insurance networks become outdated
Patients struggle to access care or are forced to wait
This is not just an administrative issue—it is a patient care issue. That’s why EduKonnekt exists.
About EduKonnekt
How credentialing works—and why it matters
Credentialing verifies a provider’s qualifications and authorizes participation in insurance networks—before billing can occur.
When done right, providers stay active, institutions remain compliant, and patients keep access to care.
Key steps (at a glance):
- Delegates & coordinators: Gather, submit, and update documentation in the OCS platform
- Insurers: Validate information across Commercial, Medicaid, and Medicare lines
- Internal teams: Billing, medical directors, and compliance ensure contracts are complete and on time
Any breakdown or delay in these steps impacts a provider’s ability to practice—and to get paid.
What EduKonnekt delivers
Role-specific training and tools to fix bottlenecks and align the system.
Structured learning: Clear tracks by role (delegates, coordinators, billing, compliance, insurers)
Real-case labs: Guided sessions to solve live credentialing issues
Law 73 alignment: Implementation guidance for Credentialing & Privileges in Puerto Rico
Operational toolkits: Checklists, templates, documentation maps, QA controls
Outcome: faster cycles, fewer errors, accurate networks, uninterrupted care.
Empowering the People Behind the System
Our Programs Support the Backbone of Puerto Rico’s Healthcare System
EduKonnekt delivers specialized programs for the professionals who make healthcare happen.
These roles long lacked formal training—until now. Each group we serve helps stabilize, streamline, and sustain Puerto Rico’s healthcare system.
Full section
Credentialing Delegates & Coordinators
The professionals who manage provider applications, documentation, and compliance—often without formal training or standardized protocols.
Their role in the industry
Delegates serve as liaisons between providers and insurance companies. They prepare and submit credentialing packets, update directories, monitor expirations, and ensure providers stay in-network and in compliance. Many learn on the job, yet are expected to master highly technical and legally binding processes.
Why EduKonnekt supports them
We deliver structured training, certification, and real-world labs so Delegates and Coordinators can elevate their role and confidently represent providers in a complex system.
What they gain
- End-to-end credentialing workflow under Law 73
- Strategic navigation of the OCS platform
- Documentation standards, timelines, and renewals
- Error prevention & resolution (contracts, network accuracy, billing impact)
- Communication skills for working with insurers and internal teams
- Toolkits: checklists, templates, documentation maps, QA controls
Outcome
Faster cycles, fewer errors, accurate networks—and greater professional confidence.
Physicians & Medical Students
Licensed physicians and final-year medical students preparing to enter Puerto Rico’s healthcare system as providers.
Their role in the system
To practice under insurance plans (Medicare, Medicaid, Commercial) and bill correctly, physicians must complete credentialing. Delays often stem from unclear requirements, missing documentation, or misalignment between credentialing and enrollment steps.
Why EduKonnekt supports them
We provide a clear, step-by-step path so new and practicing physicians can start seeing patients and get paid without unnecessary delays.
What they learn / complete
- Credentialing fundamentals under Law 73 (Puerto Rico)
- Document readiness (licenses, certifications, malpractice, CV, affiliations)
- OCS platform navigation for credentialing & privileges
- Coordination with payers (Commercial / Medicare Advantage / Medicaid)
- Common errors that delay activation—and how to avoid them
- Practical toolkits: checklists, timelines, templates, submission trackers.
Outcome
Faster activation, fewer denials, cleaner billing handoffs—and earlier revenue.
Clinical Institutions & Insurance Companies
Hospitals, clinics, health centers, and insurance carriers responsible for credentialing oversight, provider network management, and legal compliance.
Their role in the system
These organizations must collect and verify documentation, manage network adequacy, and onboard providers across multiple lines (Medicaid, Medicare, Commercial). When processes are inconsistent or siloed, the result is billing issues, outdated networks, audit findings, and compliance risk.
Why EduKonnekt supports them
We help institutions and payers build efficient, compliant credentialing operations aligned with Law 73 and OCS requirements.
What we deliver
- Department design & playbooks: org structure, roles, and RACI
- Standard operating procedures (SOPs): from intake to activation & renewals.
- Documentation controls: checklists, timelines, evidence logs, audit trails
- Payer coordination: multi-line workflows (Commercial / Medicaid / Medicare)
- Directory accuracy: source-of-truth governance, update cadence.
- Performance management: SLAs, dashboards, and exception handling
- Staff training: role-based courses + real-case labs (OCS alignment)
For insurance companies
- Centralized credentialing models to reduce variability and penalties
- Compliance mapping (Law 73 / OCS) and readiness for audits
- Network visibility: accurate directories, status tracking, and timely renewals
Outcomes
Shorter time-to-activation • Fewer denials and reworks • Reduced compliance findings • Accurate networks and clear visibility
Healthcare Affiliates (Non-MD Professionals)
Licensed healthcare professionals who are not physicians—such as physical therapists, psychologists, dietitians, speech-language pathologists, optometrists, and other allied health providers.
Their role in the system
Affiliates also require credentialing to deliver reimbursable care. Many lack visibility into the process or depend on third parties without clear oversight—leading to delays, denials, and revenue gaps.
Why EduKonnekt supports them
We offer step-by-step guidance, continuing education, and credentialing literacy so affiliates can take control of their practice, avoid disruptions, and fully integrate into the healthcare system.
What they learn / complete
- Credentialing essentials under Law 73 (Puerto Rico)
- Document readiness (licenses, board certifications, liability, NPI, CAQH/CV)
- OCS platform navigation and timelines (initial & renewals)
- Payer coordination across Commercial / Medicaid / Medicare
- Common errors that trigger denials—and how to prevent them
- Practical toolkits: checklists, templates, submission trackers, renewal calendar
Outcomes
Faster approvals • Fewer denials • Stable cash flow • Better payer relationships
Government & Regulatory Agencies
We support government agencies with education and implementation support that promotes system-wide alignment with public policy, enhances oversight & accountability, and strengthens workforce development within healthcare operations.
What we provide
- Policy-to-operations alignment: training mapped to Law 73 and OCS frameworks
- Oversight readiness: audit checklists, evidence logs, and compliance workflows
- Workforce development: role-based upskilling for credentialing.
- Standards & SOPs: intake → verification → activation → renewals (multi-line: Commercial/Medicaid/Medicare)
- Data governance: directory accuracy, documentation controls, and update cadence
- Interagency coordination: shared templates, metrics, and escalation paths
Outcomes
Clearer compliance, better network visibility, faster time-to-activation, and a stronger, more capable workforce across the system.
A Strong Executive Team
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