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3 Part Series Credentialing & Provider Enrollment: Basics to Advanced

All Days
Healthcare | Recorded Webinar | Duration: 180 Minutes
Yesenia Servin

Live webinar instructions will be emailed to you 3 days prior to the event. || The recording, digital download, and full transcript will be available within 48 hours after the webinar.
Description

Part 1 | 1 PM EST: Credentialing Foundations: Navigating Medicare Enrollment for Providers

Title: Medicare Provider Enrollment 101: Complete Enrollment and Credentialing Process for Providers

Overview:

This session guides healthcare professionals through the complexities of Medicare provider enrollment, credentialing, and revalidation. It explains CMS-855 forms and emphasizes credentialing's role in the revenue cycle.

Learning Objectives:

Gain an overview of CMS connections necessary for compliant Medicare provider applications.

  • Understand the distinctions between Part A facility applications and Part B organization and individual applications.
  • Learn about reassignment applications and the revalidation process for various CMS-855 forms.
  • Review each section of the application within the PECOS system.
  • Familiarize yourself with payer-specific rules and requirements for both government and commercial payers.

Topics Covered:

  • Credentialing & Enrollment
  • Joining the Network
  • First Action Steps (I&A, NPI, NPPES, CAQH, Fee Schedules)
  • Portals & Profiles
  • Delegated vs. Non-Delegated Credentialing
  • Building a Credentialing Database
  • CMS & Availity Connections

Who Should Attend:

Credentialing Specialists, Revenue Cycle Managers, Enrollment Specialists, Hospital Administrators, Mental Health Professionals

Part 2 | 1 PM EST: Credentialing in Practice: Document Management and Payer Applications

Title: Credentialing and Provider Enrollment 102

Overview:

A deeper dive into credentialing and provider enrollment. Includes document handling, payer communications, system setup, and customizable tools.

Topics Covered:

  • Provider Documentation Requirements
  • Verification and Validation
  • Document Tracking
  • System Maintenance (CAQH, PECOS, NPPES, I&A)
  • Payer Applications (Medicare, Medicaid)
  • Communication Strategies
  • Post-Approval Steps
  • Tools Provided: Printable/customizable forms and tracking tools

Learning Objectives:

  • Understand setup and maintenance of systems like CAQH, PECOS, NPPES, and I&A.
  • Learn the full payer enrollment process.
  • Gain knowledge of payer requirements and submissions.
  • Develop skills to track applications effectively.

Who Should Attend:

Practice Managers, Credentialing Specialists (PESC, CPMSM), Revenue Cycle Directors, CFOs, and related professionals.

Part 3 | 1 PM EST: Advanced Credentialing: Mastering NPPES, PECOS, and CMS I&A Accounts

Title: Credentialing and Provider Enrollment 103

Overview:

Advanced strategies for managing multiple systems and payer enrollments, with a focus on CMS platforms and surrogacy account management.

Topics Covered:

  • CMS I&A System Setup
  • NPPES Management
  • Payer Enrollment Applications
  • Application Tracking
  • Surrogacy Program Utilization

Learning Objectives:

  • Set up, maintain, and attest NPPES and I&A accounts.
  • Complete payer applications accurately.
  • Navigate payer-specific requirements.
  • Track enrollment effectively.
  • Manage multiple NPI profiles.

Who Should Attend:

Practice managers, credentialing specialists (PESC, CPMSM), revenue cycle directors, CFOs, and those involved in provider enrollment and EFT operations.

Rhanda McKown

Yesenia Servin

Yesenia Servin CPMSM, PESC 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.

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