Credentialing New Provider: Get Reimbursed Higher and Faster

Course Description:

When onboarding a new physician into your practice, your process must be flawless. The slightest mistake can result in significant reimbursement delays – or worse, payer rule violations. There are a many details you must get right the first time. Failure to do so can significantly delay your new provider from being eligible to see patients and get paid. Even simple errors can get your set-up/transfer documents thrown out. Then you’ll be required to go through the entire process all over again.

It is vital that your new physician starts to see patients and get paid as soon as possible. David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, will walk you through each step of creating, implementing, and optimizing your new provider onboarding process. You can make your onboarding process more efficient and accurate. You can speed up your billing process and get paid more quickly.

Even an innocent mistake during the provider onboarding process can have profound financial implications for your practice. You must get it right the first time to avoid difficult-to-fix payer setup errors that will significantly delay reimbursements. Everyone at your practice (including the patients) depends on you to get your new doctor up and running as quickly and efficiently as possible, and this upcoming online training can show you how.

Learning Objectives:

• Understand how all organizations bleed cash and they don’t know it
• Understand the differences between privileging, delegated credentialing vs provider enrollment and how they interact
• List common mistakes that can be made when there is not a process in place
• Learn why it is important to work as a proactive team to onboard a new provider
• Understand the process of onboarding a practitioner and dealing with his/ her departure
• Know how to guarantee productivity and predictive cash flow from day 1 by establishing solid policies and procedures

Areas Covered in the Session:

• Checking your processes whether it’s inefficient or not
• Learn the top reasons for losing money on providers
• What laws help to protect the provider and practice when contracting and credentialing
• Learn what keep you up at night and how to sleep better
• How to get buy-in from the providers and ownership
• Learn which payors you can retroactively bill for services
• Predictive cash flow and how you can attain this status
• Is it better for a new provider to bill under their NPI or your practice’s?
• When is it possible to start credentialing for a new doctor before they arrive?
• How can a new physician see patients before they are fully credentialed?
• When and how must new doctors re-attest with PECOS and CAQH?
• When can a new provider bill under another physician’s name at your practice?
• How can you speed up a new provider’s Medicare enrollment transfer?
• When is filing for temporary hospital privileges worth your time?
• Can a new physician bill for services under the supervision of another provider?
• If a new provider’s documents are not all in, can they still bill for their services?
• How can you get your payer plans to approve a new physician more quickly?
• Live Q&A session

Suggested Attendees:

• Healthcare CEOs
• Healthcare CFOs
• Healthcare COOs
• Office Managers
• Administrators
• Billing Staff and Companies
• Physicians and Other Providers
• Healthcare Consultants
• Compliance Officers
• Physicians
• Nurses
• Practice Manager

About the Presenter:

David J. Zetter, PHR, SHRM‐CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 30 years of operational and healthcare experience. David is nationally recognized for his presentations and expertise. He is well-versed in regulatory requirements, revenue cycle management, credentialing and contracting, compliance, coding and documentation. He is considered an expert on Medicare, not only by his clients but his consultant colleagues across the country. He has evaluated existing ambulatory care facilities and practices with respect to patient flow, operations, marketing, fee structures, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. His activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types, including coding and broad‐based regulatory issues. David has also conducted chart audits on behalf of Medicare contractors and Blue Cross/ Blue Shield early in his career, so he has knowledge of what the expectations are from the payers. David’s firm works with healthcare professional clients and facilities coast to coast, in all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, governance documentation, policy and procedure development and implementation, credentialing and contracting, human resources staffing and management, compliance, coding and chart reviews, physician education and many other areas. David has helped to maximize both profitability and reimbursement of physician practices, facility and ambulatory practices, re‐engineered operational and human resources, and addressed coding and billing issues for providers to curtail fraud, abuse, kickback, OIG, and IRS issues. He is also an original member of CMS’ PECOS Power User Group, CMS Compliance Focus Group and MIPS Design Lean Work Group which provides feedback and recommendations to Medicare’s Center for Program Integrity and Provider Enrollment Operations Group on design and improvements to the PECOS enrollment environment, as well as, NPPES and MIPS and conducts beta testing of the EHR/ HITECH user interfaces and environments at the request of the Office of e‐Health Standards & Services Director. David is also on the CMS contracted team awarded the PECOS 2.0 contract to rebuild PECOS from the ground up. David has conducted practice management, human resource, coding and compliance education and seminars in many states over the past twenty‐five years. David speaks often on a variety of practice management subjects at hospital residency programs, the National Society for Certified Healthcare Business Consultants, the Medical Management Group Association, the American Academy of Professional Coders, AHIMA, Florida Institute of Certified Public Accountants, Florida Medical Society, many other venues and is often called upon by the MGMA, HFMA, DecisionHealth, Part B News, Part B Insider, and many others, to conduct audio conferences and webinars. He has been published in Medical Economics and interviewed and quoted in many publications including Report on Patient Privacy and Report on Medicare Compliance.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

Snippet From Our Previous Session:

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Testimonials:

"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"

Melissa Preston, Health Information Management Staff

"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN" 

Sandie Fowler, Out of Network Billing Staff

"Great presentation. Able to do during the day. Timing was great"

Tina Duffy, Compliance Officer