Enrolling With Payors: Speed Up Enrollment, Credentialing and Contracting Approval and Payments

Conference Materials (Password Required)

If you’re new to enrolling, contracting, and credentialing providers with private/ commercial payers, join Yesenia Servin as she shares best practices for completing these tasks and tell how to do these processes efficiently, identify red flags that will require special attention, and practice ongoing maintenance. This professional presentation will provide training and guidance on creating a successful medical/ health practice. The presenter will go over crucial steps that impact your revenue cycle; including insurance credentialing and contracting and provider enrollment. Providers will understand how to create an efficient credentialing/ enrollment process and understand the connection with a healthy revenue cycle. During this webinar, providers will understand CAQH, NPPES, I&A, Availity, ERA and EFTs, and Medicare portals.

Some basic knowledge of the enrollment/ credentialing area is required, but you need not have in-depth knowledge or skills. The presenter, Yesenia Servin will provide information at a level beyond the basic knowledge of the topic. Program content focuses on ethical, best practice or regulatory policies, guidelines, and standards that influence healthcare practice, education, or research.

Learning Objectives:

• Assess structure needed to build a Successful payer/ provider enrollment practice
• Discuss credentialing & enrollment processes that impact your revenue cycle
• Recognize the various insurance payers, including private/ commercial and government and each enrollment process
• Understand current enrollment/ credentialing regulatory policies, guidelines, and standards
• Know the complete process of enrollment with both private and government payers

Areas Covered in the Session:

• Provider Enrollment
• Credentialing
• Preparation
  • Provider: Organization Name
    • As listed on the IRS letter
    • DBA listed on W9
  • Provider: Individual Name
    • As listed on professional paper
    • SSN registration
  • EIN/TIN/SSN
    • Organization
    • Individual
  • CMS Identity & Access (I&A)
    • I&A
      • Medicare Participation
    • NPPES – NPI
    • PECOS
      • Initial Enrollments
      • Revalidations
      • Reassignments
      • Terminations
    • CAQH Profile
      • Practice Manager
      • Groups
      • Individual Providers
  • Fee Schedule
• Credentialing / Enrollment Tech & Tools
  • Cred/Enroll Systems
  • CAQH
  • Excel, Access
  • Onboarding Tools
• Recruiting / Onboarding
  • Communication
  • Documentation
• Discovery
• Data & Documentation
• Medicaid
  • State Regulations & Rules
  • Organization
  • Individual
  • As of 2021, 21.1% of the US population have Medicaid
• Medicare
  • CMS Regulations & Rules
  • Organization
  • Individual
• Tricare, VA, VA CCN
• Independent Physician Association (IPA)
• Physician Hospital Organization (PHO)
• Clinically Integrated Network (CIN)
• Private, Commercial
• Professional Profiles
• Telehealth
  • Government
    • Federal
    • State
  • IPA / PHO / CIN
  • Commercial / Private
  • Directories
• Onboarding

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
• Certified nursing assistants

Presenter Biography:

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This is a Live Virtual session.

A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.

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Snippet From Our Previous Session