National Provider Enrollment Forum

September 20-21, 2021 | Nashville, TN

Main Conference Track A - Provider Enrollment

Monday, September 20, 2021
7:00 a.m. – 8:00 a.m.
REGISTRATION & CONTINENTAL BREAKFAST

WELCOME/OPENING REMARKS

8:00 a.m. – 9:00 a.m.
Provider enrollment
9:10 a.m. – 10:10 a.m.
The Enrollment Process With PECOS, I&A, and NPPES

Join David Zetter as he explains how the Provider Enrollment, Chain, and Ownership System (PECOS) works in tandem with the Identity & Access Management System (I&A) as well as the National Plan and Provider Enumeration System (NPPES) during the provider enrollment process. Zetter will also detail the multifactor authentication process and the different roles of delegated officials, authorized officials, and surrogates.

10:10 a.m. - 10:40 a.m
NETWORKING & REFRESHMENT BREAK
10:40 a.m. – 11:40 p.m.
Payer Credentialing & Provider Enrollment: Two Sides of the Same Coin

Timely provider enrollment with payers is a critical function to enable provision of care and business success. This session will look at both sides of the credentialing process in the commercial payer world. Understanding a health plan’s requirements under NCQA and CMS can help a provider organization develop an efficient enrollment process for its employed or contracted healthcare practitioners, including the potential for achieving delegation status.

11:40 a.m. – 12:40 p.m.
NETWORKING LUNCH—Provided
12:40 p.m. – 1:40 p.m.
Increase Revenue With Improved New Provider Onboarding

Avoid losing money and productivity by guaranteeing that you collect payments for all your practitioners’ services from the day they start. Having a strong new provider onboarding process ensures practitioners can begin receiving reimbursement immediately upon starting. In this session, David Zetter will offer suggestions and actionable guidance to improve your onboarding process.

1:50 p.m. – 2:50 p.m.
Optimize Revenue With Unification of Provider Enrollment, Credentialing, and Privileging

Organizations strive to hire quality physicians who have a positive impact on revenue and patient satisfaction. However, organizations risk losing revenue if physicians have to wait to get credentialed—and unfortunately, many hospitals and health plans have a credentialing process that is complex, time-consuming, or duplicative. This session will provide specific tips and tools to remove the hassle factors for physicians by streamlining processes. Attendees will learn how to gain operational efficiencies and speed up turn-around times, resulting in cost savings, positive impact on revenue, and physician and patient satisfaction.

2:50 p.m. - 3:20 p.m.
NETWORKING & REFRESHMENT BREAK
3:20 p.m. - 4:20 p.m.
An Introduction to Contracting With Commercial Payers

New to enrolling, contracting, and credentialing with commercial payers? Join David Zetter as he provides an introduction and explains what you can expect from the overall process, the vendors, and your staff during commercial payer enrollment. You’ll walk away with best practices you can use to ensure success.

4:30 p.m. - 5:30 p.m.
Developing a Practitioner Health and Wellness Committee

Practitioners face increasing challenges and demands from employers, patients, and daily life. MSPs, medical staff, and hospital leadership play a significant role in practitioner health and wellness, and they should be committed to prioritizing physicians’ well-being. This session will provide guidance and targeted solutions to support your organization in the development of a Practitioner Health and Wellness Committee.

5:30 p.m.
Conference Adjourns

Main Conference Track B - Credentialing

Monday, September 20, 2021
7:00 a.m. – 8:00 a.m.
REGISTRATION & CONTINENTAL BREAKFAST
8:00 a.m. – 9:00 a.m.
Achieving NCQA Recognition in Credentialing

Attaining NCQA recognition as a credentialing organization demonstrates compliance with specific industry credentialing requirements and provides opportunities for significant efficiencies and marketability, including delegation status with payers and streamlined enrollment. This session will outline the NCQA requirements for CR accreditation and CVO certification to help organizations determine eligibility and achieve success through proven survey management tools and techniques.

9:10 a.m. – 10:10 a.m.
Verify & Comply: Part 1

This session begins our two-part examination of the biggest pain points in CMS regulations and accreditors’ medical staff and credentialing standards. During this pair of sessions, attendees will learn each accreditor’s requirements, their similarities and differences, and compliance best practices. Speaker Janet Wilson will provide strategies for successful standards compliance.

10:10 a.m. - 10:40 a.m
NETWORKING & REFRESHMENT BREAK
10:40 a.m. – 11:40 p.m.
Verify & Comply: Part 2

This session continues our two-part examination of the biggest pain points in CMS regulations and accreditors’ medical staff and credentialing standards. Speaker Janet Wilson will continue her explanation of the similarities and differences between each accreditor’s requirements and provide strategies for standards compliance.

11:40 a.m. – 12:40 p.m.
NETWORKING LUNCH—Provided
12:40 p.m. – 1:40 p.m.
Use Delegated Credentialing to Eliminate Enrollment Delays

Waiting for payers to complete their credentialing process takes time and can result in lost or delayed revenue. An efficient enrollment process is critical to a healthcare organization's revenue cycle, and attaining delegated status with commercial payers allows organizations to enroll new providers faster and eliminate enrollment delays. Attendees of this session will learn the steps to achieve delegation status, including determining eligibility and establishing a compliant credentialing program.

1:50 p.m. – 2:50 p.m.
Medical Staff Unification

CMS revised its Conditions of Participation in 2014 to allow multihospital systems to have one unified medical staff. Medical staffs must decide if the best option for all involved is consolidating governing documents and creating a single process for credentialing, privileging, and peer review. Todd Sagin will cover current medical staff unification trends and lay out legal and cultural considerations to help attendees decide whether their health system could benefit from having a unified medical staff.

2:50 p.m. - 3:20 p.m.
NETWORKING & REFRESHMENT BREAK
3:20 p.m. - 4:20 p.m.
Is an Aging Physicians Policy Necessary? 

Medical staff leaders must assess each practitioner’s capacity to perform all requested privileges, but telling a colleague that their age may be affecting their ability to care for patients can be difficult. To avoid singling out older practitioners, some medical staffs have begun implementing policies that spell out stricter vetting and monitoring processes for practitioners of a certain age. Other medical staffs worry that those very policies are what single out practitioners. Attendees of this session will receive guidance to determine if an age-related policy is right for their organization. Todd Sagin will also identify resources for fitness-for-duty screenings and discuss legal issues that could arise from over-vetting or under-vetting late-career practitioners.

4:30 p.m. - 5:30 p.m.
Maintain Your Organization's Delineation of Privileges

Organizations have an obligation to their patients to ensure practitioners are only providing care and services that they are qualified to perform. This is in addition to accreditor and regulatory requirements for current privilege forms and criteria. Speaker Janet Wilson will discuss the roles and responsibilities that key players have in the privileging process and will provide attendees with guidance to develop collaborative, ongoing, and systematic approaches to privilege form updates and maintenance.

5:30 p.m.
Conference Adjourns

Main Conference Track A - Provider Enrollment

Tuesday, September 21, 2021
7:00 a.m. – 8:00 a.m.
REGISTRATION & CONTINENTAL BREAKFAST
8:00 a.m. – 9:00 a.m.
Provider enrollment
9:10 a.m. – 10:10 a.m.
How Changes of Ownership Impact Healthcare Transactions

As consolidations and acquisitions continue in the healthcare industry, knowing what types of transactions trigger a change of ownership and what notices must be filed is critical to avoid a lapse in reimbursement or a closing of the transaction. Brian Jent will use real-life examples to address specific change of ownership situations, providing attendees with practical guidance should they ever encounter those circumstances.

10:10 a.m. - 10:40 a.m
NETWORKING & REFRESHMENT BREAK
10:40 a.m. – 11:40 p.m.
Stepping Up Your Game: Payer Enrollment Best Practices

Payer enrollment is an ever-evolving field—one where an overlooked data point can cause reimbursement delays. Join Team Med Global’s Larry DeHoyos and Yesenia Servin as they provide insights into the latest trends in payer enrollment and actionable information to increase the effectiveness of experienced payer enrollment specialists and team leaders.

11:50 a.m. – 12:50 p.m.
How to Avoid a Denial of a CMS-855 Form

Learn best practices for avoiding rejection of a CMS-855 form, as well as what to do when appealing rejections. During this session, healthcare consultant Todd Selby will use case law examples of rejections to explain why they happened and demonstrate how attendees can apply his guidance to real-life scenarios.

12:50 p.m. – 1:50 p.m.
NETWORKING LUNCH—Provided
1:50 p.m. – 2:50 p.m.
Building Your Provider Enrollment Toolbox

Do you have all of the provider enrollment tools you need to be effective? Or do you only have a hammer? This session will provide real-world tools that provider enrollment professionals can use to address a multitude of functions. The presentation materials double as checklists that can be used in daily work.

2:50 p.m. - 3:20 p.m.
NETWORKING & REFRESHMENT BREAK
3:20 p.m. - 4:20 p.m.
Successfully Manage Provider Enrollment and Medicare Revalidations

Never miss recredentialings or Medicare revalidations by keeping your information updated and accurate with payers to ensure a successful practice. This session provides tips and best practices for staying organized and informed, while keeping payers up to date with your practitioners’ and group’s information.

4:20 p.m.
Conference Adjourns

Main Conference Track B - Credentialing

Tuesday, September 21, 2021
7:00 a.m. – 8:00 a.m.
REGISTRATION & CONTINENTAL BREAKFAST
8:00 a.m. – 9:00 a.m.
Master Ongoing Credentialing Monitoring Requirements

Once practitioners are credentialed, they are immediately subject to ongoing monitoring for continued compliance and potential issues. This function is critical to ensure quality patient care, but also to ensure that the organization is in compliance with accreditation and regulatory requirements and not subject to fines or other corrective action. This session will provide a focused review of the CMS, Joint Commission, and NCQA credentialing requirements for ongoing monitoring, including implementation tips and leading practices to ensure compliance and reduce risk.

9:10 a.m. – 10:10 a.m.
Why You Need an Effective Medical Staff Confidentiality Policy and Process

Confidentiality is a crucial element of the medical staff and credentialing industry. Speaker Janet Wilson will help attendees identify the key components needed in a comprehensive confidentiality policy. She will also demonstrate how to establish internal guidelines and processes using a confidentiality policy that’s effective and accountable.

10:10 a.m. - 10:40 a.m
NETWORKING & REFRESHMENT BREAK
10:40 a.m. – 11:40 p.m.
How Physician Leaders and MSPs Can Ensure Successful Credentialing Integration

In today’s integrated healthcare environment, credentialing has evolved into a mega process with far-reaching implications. That means the MSP’s job is more significant and expansive than ever. Medical staff leaders should understand the vital role MSPs play in the organization and the importance of a solid and efficient credentialing process. Attendees of this session will learn how MSPs can be instrumental in maximizing an organization’s financial position; how the efficiency of credentialing directly affects revenue enhancement and physician satisfaction; and how physician leaders and MSPs can work together to create a credentialing process that protects patients and supports practitioners.

11:50 a.m. – 12:50 p.m.
Boosting the Bottom Line: Linking Healthcare Quality Data and Revenue Management

Healthcare quality data is increasingly tied to an organization’s revenue streams. This means physician performance metrics are more than a credentialing tool. Join Team Med Global’s Stephanie Russell and Nicole Keller in exploring the connections between credentialing, revenue management, and healthcare quality data.

12:50 p.m. – 1:50 p.m.
NETWORKING LUNCH—Provided
1:50 p.m. – 2:50 p.m.
Lessons Learned: Reflections on Disaster Privileging & Enrollment

The COVID-19 pandemic unleashed a flood of challenges for credentialing and payer enrollment specialists. Although CMS and states granted waivers for credentialing, payers typically didn't have a process to handle provider enrollment. Join Team Med Global’s Donna Goestenkors and Rachelle Silva as they reflect on the lessons learned during disaster privileging and enrollment, and how these lessons can inform process improvements moving forward.

2:50 p.m. - 3:20 p.m.
NETWORKING & REFRESHMENT BREAK
3:20 p.m. - 4:20 p.m.
Optimize Revenue With Unification of Provider Enrollment, Credentialing, and Privileging (REPEAT)

Organizations strive to hire quality physicians who have a positive impact on revenue and patient satisfaction. However, organizations risk losing revenue if physicians have to wait to get credentialed—and unfortunately, many hospitals and health plans have a credentialing process that is complex, time-consuming, or duplicative. This session will provide specific tips and tools to remove the hassle factors for physicians by streamlining processes. Attendees will learn how to gain operational efficiencies and speed up turn-around times, resulting in cost savings, positive impact on revenue, and physician and patient satisfaction.

4:20 p.m.
Conference Adjourns
Register Today