Medicare & Medicaid Managed Care Enrollments

Course Description:

What is managed care Medicaid and how is it different from traditional Medicaid. Knowing current Medicaid rules is crucial to bill and be reimbursed by Medicaid for services provided. Provider agencies should be enrolled in Medicaid and must have a National Provider Identification (NPI) number to ensure proper reimbursement. This webinar will take you through the process of obtaining NPI and the complete enrollment and credentialing process for Medicaid and Medicare. How do Medicare Advantage plans work and how are they different from traditional Medicare? How do I manage all of these plans and products as a credentialing and enrollment professional? How do I educate myself and all the stakeholder in my organization about the process?

In this session you will learn the definition of each of these plans, the requirements and the process you have to take to enroll your organization and individual providers successfully to these plans.

Learning Objectives:

  • Understand & define medicaid managed care plans
  • Understand medicare advantage plans and it’s rules and requirements
  • Learn the enrollment process for these plans/ products for your organization
  • Discuss and review the enrollment process for these plans/ products for your individual providers
  • Know credentialing and enrollment process for Medicaid and Medicare Plans

Areas Covered in the Session:

  • Medicaid Managed Care Plans
  • Medicare Advantage Plans
  • Traditional Medicaid
  • Traditional Medicare
  • Credentialing
  • Enrollment
  • Application Process
  • Revenue Cycle
  • CMS Current Rules and Regulations
  • Federal and State Medicaid Rules
  • Live Q&A session

Suggested Attendees:

  • Healthcare CEOs
  • Healthcare CFOs
  • Healthcare COOs
  • Credentialing Specialist
  • Revenue Cycle Managers
  • Enrollment Specialist
  • Hospitals
  • Mental Health Providers
  • LCPC
  • LMFT
  • Practice, Clinic Owners
  • Hospital Leadership
  • Authorized Officials 
  • Delegated Officials 
  • Revenue Cycle Directors 
  • Credentialing
  • 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

About the Presenters:

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.

Yesenia manages payer enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payer-enrollment processes. Yesenia works with durable medical equipment, hospital and health systems, and community mental health organizations, global managed care organizations as well as providing revenue cycle consulting services to various healthcare providers and organizations. 

Yesenia is a current CharterOak University Faculty, NAMSS member, and is a past NAMSS Educational Conference Guest Speaker, a current member of the NAHRI Leadership Council, current trainer for The Chicago School of Professional Psychology trainer and a TMG Collaborator. Yesenia studied microeconomics and communications at NEIU and healthcare administration at Concordia University Chicago.

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

Snippet From Our Previous Session:

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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

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Medicare & Medicaid Managed Care Enrollments

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