National Provider Enrollment Forum

September 20 - 23, 2020 | Nashville, TN


Sunday, September 20, 2020
12:00 p.m. - 1:00 p.m.
Preconference REGISTRATION
1:00 p.m. – 2:10 p.m.
Provider Enrollment 101

Industry veteran Terri Lynn Davis kicks off the preconference with an essential session on the foundations of provider enrollment. Learn important terminology, the steps in the enrollment process, and the difference between commercial and government payers.

2:10 p.m. – 2:40 p.m.
Networking and Refreshment Break
2:40 p.m. – 3:50 p.m.
Introduction to PECOS/I&A and Surrogacy

Experienced healthcare consultant David Zetter breaks down the Provider Enrollment, Chain, and Ownership System (PECOS), the Identity & Access Management System, and the National Plan & Provider Enumeration System (NPPES) into easy-to-understand pieces in this session. Zetter also introduces surrogacy and explains its importance.

4:00 p.m. – 5:15 p.m.
What Is the Difference Between Credentialing and Payer Enrollment?

Join Terri Lynn Davis as she outlines the essential tasks involved in credentialing and payer enrollment. Learn the overlaps and differences between the two functions in this session. Davis also explains the process of primary source verification and the processes for enrolling both new and existing practitioners and facilities.

5:15 p.m.

Main Conference Day 1

Monday, September 21, 2020
7:00 a.m. - 8:00 a.m.
8:00 a.m. – 9:00 a.m.
2020 Enrollment Regulations Updates

Get up to date on all new and upcoming regulatory changes, particularly regarding CMS and Medicare. Plus, get clarity on recent and upcoming changes to enrollment processes.

9:10 a.m. – 10:10 a.m.
Identity & Access, PECOS, NPPES, and CMS’ Surrogacy Program: Successful Setup and Access to Your Providers/Suppliers

Master the PECOS Identity & Access Management System to request surrogacy on behalf of providers. Plus, David Zetter clarifies how Delegated Officials and Authorized Officials take on different meanings when performing enrollment vs. acting as a surrogate.

10:10 a.m. – 10:40 a.m.
Networking and Refreshment Break
10:40 a.m. – 11:40 a.m.
Maintaining Provider Enrollment and Performing Medicare Revalidations

Keeping your information updated and accurate with payers is crucial to a successful practice. This session provides tips for remaining organized, staying informed, and keeping payers up to date with your practitioners’ and group’s information. These best practices will help you ensure that no recredentialing or Medicare revalidations are ever missed.

11:40 a.m. – 12:40 p.m.
Lunch (Provided)
12:40 p.m. - 1:40 p.m.
How to Complete the CMS-855I

Lauren Hulls explains in detail how to complete the CMS-855I form to enroll physician and nonphysician practitioners with Medicare. Attendees will also have the opportunity to ask specific questions regarding the form’s different sections.

1:50 p.m. – 2:50 p.m.
Credentialing Across the Continuum

This session provides a broad overview of the regulatory and accreditation standards required throughout the healthcare industry. Industry veteran Rachelle Silva discusses primary source verification requirements as well as how to develop clear and concise policies.

2:50 p.m. - 3:20 p.m.
Networking Break and Refreshment Break
3:20 p.m. - 4:20 p.m.
Contracting With Commercial Payers

Join David Zetter for an introduction to enrolling, contracting, and credentialing with commercial payers. Learn what to expect from the overall process, the vendors, and your staff when enrolling with commercial payers. Zetter also provides best practices for successful enrollment with these payers.

4:30 p.m. - 5:30 p.m.
Introduction to CAQH Solutions

Join industry experts Christopher Swartz and Jammal Dorsey as they discuss how healthcare organizations are benefiting from the usage of CAQH services. Specifically, Swartz and Dorsey showcase real-world examples of how those solutions have improved provider data management and credentialing processes for health plans.

5:30 p.m. – 6:30 p.m.
Networking Reception

Main Conference Day 2

Tuesday, September 22, 2020
7:00 a.m. - 8:00 a.m.
Main Conference Day 2 Continental Breakfast
8:00 a.m. - 9:00 a.m.
New Provider Onboarding: Resolving the Hidden Cash Flow Drain

Would you like to guarantee payment for all services conducted by your practitioners from the day they start, without losing any money or productivity? In this session, David Zetter offers suggestions and actionable guidance to improve your new provider onboarding process so that practitioners can begin receiving reimbursement immediately upon starting.

9:10 a.m. - 10:10 a.m.
Drowning in Duplication: Let’s Explore the Benefits of Delegation

This session evaluates the duplication in the credentialing process and explores the benefits of entering into delegated credentialing agreements to improve the timeliness of beginning the revenue cycle. Speaker Rachelle Silva also discusses professional development for provider enrollment specialists.

10:10 a.m. - 10:40 a.m.
Networking and Reception Break with PECOS Station
10:40 a.m. - 11:40 a.m.
Streamlining Data Exchange in Delegated Credentialing Relationships

Health plans and provider groups across the country are beginning to adopt a data standard for exchanging delegated rosters to support reporting in delegated credentialing relationships. CAQH has built a portal called CAQH ProView for Groups that aligns with this standard and allows provider groups to submit rosters in a one-stop shop for multiple health plans. Learn how the standard is helping both provider groups and health plans streamline data exchange and other processes, and how this improves transparency between health plan and provider groups in provider enrollment and other use cases.

11:40 a.m. - 12:40 p.m.
Lunch (Provided)
12:40 p.m. - 1:40 p.m.
How to Complete the CMS-855 Forms, Part 1

Learn how to successfully complete the CMS-855A, CMS-855B, and CMS-855R to enroll or revalidate providers and suppliers with Medicare and to reassign a practitioner’s Medicare benefits. Attendees also have the opportunity to ask questions regarding the forms.

1:50 p.m. - 2:50 p.m.
How to Complete the CMS-855 Forms, Part 2

Learn how to successfully complete the CMS-855A, CMS-855B, and CMS-855R to enroll or revalidate providers and suppliers with Medicare and to reassign a practitioner’s Medicare benefits. Attendees also have the opportunity to ask questions regarding the forms. Note: This session is a continuation of How to Complete the CMS-855 Forms, Part 1.

2:50 p.m. - 3:30 p.m.
Networking and Reception Break with PECOS Station
3:20 p.m. - 4:20 p.m.
How to Cope With and Respond to Denials of CMS-855 Forms

Gain insight into why CMS-855 forms may be rejected and learn best practices for appealing rejections as well as avoiding them altogether. Healthcare consultant Todd Selby also provides case law examples of rejections to demonstrate how to apply this guidance to real-life scenarios.

4:20 p.m. - 5:30 p.m.
Payer Enrollment Challenges: Advanced Practice Professionals

Payer enrollment specialists are adept at juggling and tracking multiple providers. However, advanced practice professionals—such as nurse practitioners, physician assistants, and registered nurse anesthetists—can pose specific challenges to an industry once geared to physicians. Join Team Med Global’s Donna Goestenkors and Yesenia Servin as they discuss mechanisms to streamline payer enrollment for nonphysician practitioners and achieve optimal revenue recovery.

5:30 p.m.

Main Conference Day 3

Wednesday, September 23, 2020
7:00 a.m. - 8:00 a.m.
Main Conference Day 2 Continental Breakfast
8:00 a.m. - 9:10 a.m.
Beyond the Basics: 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 Donna Goestenkors and Nicole Keller as they provide insights into the latest trends in payer enrollment and supply actionable information to increase the effectiveness of experienced payer enrollment specialists and team leaders.

9:20 a.m. - 10:20 a.m.
CHOW Down: Understanding How Changes of Ownership Can Impact a Healthcare Transaction

In recent years, the healthcare industry has seen a lot of consolidation and acquisition activity. 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. This session provides guidance on specific change-of-ownership situations through real-life examples.

10:20 a.m. - 10:50 a.m.
Networking and Refreshment Break
10:50 a.m. - 12:00 p.m.
Jumpstarting Reimbursement: Mastering Medicaid Payer Enrollment

Payer enrollment accelerates an organization’s revenue cycle, but Medicaid turnaround times, retroactive physician enrollment, and out-of-state physician enrollment can put the brakes on timely reimbursements. To reverse delayed enrollment and streamline the payer process, join Team Med Global’s Donna Goestenkors and Larry DeHoyos as they discuss best practices for handling Medicaid enrollments to achieve your enrollment goals and circumvent stalled reimbursements.

12:00 p.m.