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CMS 855 Forms for Medicare Enrollment
Event Date: 04/20/2023
Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT
Duration of the training: 60 Minutes
Location: Online Webinar
By: Yesenia Servin, CPMSM, PESC

Conference Materials (Password Required)

Enrolling with the Medicare program involves the various CMS-855 forms. There are now different forms that must be used by different providers of healthcare services or products. These forms are long, detailed and sometimes confusing. Not only must they be filed initially for given provider, they must be maintained and updated as appropriate. Due to the increasing complexity of healthcare delivery systems, providers, such as integrated delivery systems or large multi-specialty clinics, may have to maintain hundreds of these forms.

Join expert Yesenia Servin, CPMSM, PESC, for this detailed review of the CMS 855 forms for Medicare participation. We will review both the paper applications and PECOS applications, Facility apps, Organization apps, Individual apps.

Learning Objective:
  • Understand part A Facility applications
  • Understand part B organization app and individual apps
  • Understand reassignment apps
  • To review the Medicare enrollment process through the use of the various CMS-855 forms
  • To address changes to the CMS-855 forms and/or changes in interpretations of the forms
  • To discuss the revalidation process for the various CMS-855 forms
Areas Covered in the Session:
  • CMS 855 A
  • CMS 855 B
  • CMS 855R
  • CMS 855 I
  • EFT
  • Medicare PAR
  • Medicare Reassignment
  • Medicare PART B
  • Medicare PART A
  • Revalidation Process
    • Revalidation cycles
    • Time frames for completion
    • Risk level
  • Common errors causing return of application
  • Time frames and best practices for follow-up during the process
  • Important information on required information
Suggested Attendees:
  • Authorized officials
  • Delegated officials
  • Revenue cycle directors
  • Credentialing
  • Enrollment
  • Office Manager
  • Revenue Cycle
  • Operations
  • Billing Team
  • In and Out of Network Providers
  • Medical Billing Companies
  • Providers’ Office Staff
  • Physician
  • Hospitals and Facilities
  • Insurance Companies
  • Healthcare Attorneys
  • Executive and Administrators
  • Front Desk
  • Scheduling
  • Authorizations Staff
  • Medical Assistants
  • CNA’s
Presenter Biography:

Yesenia Servin is an expert in credentialing and provider/payer enrollment with over 23 years of experience in the healthcare industry. Yesenia has a deep understanding of Medicare & Medicaid enrollment and is a nationally certified credentialing manager and provider enrollment specialist. Through, YS Credentialing PLLC, Yesenia helps organizations develop and implement best practices guidelines and processes. Guides the credentialing and payer enrollment structure. Thrives on training and growing administrative, credentialing and enrollment healthcare professionals.

Yesenia manages payer enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payer-enrollment processes. Yesenia works with durable medical equipment, hospital and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations.

Yesenia is a current CharterOak University Faculty, NAMSS member, and is a past NAMSS Educational Conference Guest Speaker, a current member of the NAHRI Leadership Council, current trainer for The Chicago School of Professional Psychology trainer and a TMG Collaborator. Yesenia studied microeconomics and communications at NEIU and healthcare administration at Concordia University Chicago.

Yesenia enjoys spending time with her family and pugs. She finds great joy in visiting and trekking the great US states and regions.

Snippet From Our Previous Session


“Jim Sheldon-Dean’s insights on privacy and security were very much helpful to our team, it was great to learn from an instructor like him. Appreciate!”

“This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course.”

“The workshop was very insightful and made absolute sense in terms of the regulations and their compliance. I am thankful for having the opportunity to attend.”