Payor Enrollment and Credentialing New Rules for 2023 and 2024
Format: Live Webinar
Presenter: Yesenia Servin, CPMSM, PESC
Event Date: TBD
Time: 3 pm ET | 2 pm CT | 1 pm MT | 12 pm PT
Duration: 60 minutes
Course Description:
This presentation will provide training and guidance on creating a successful payor credentialing & enrollment process and review how these processes impact claims submissions and receive claims reimbursement from different payors. The presenter will go over crucial steps including credentialing, provider enrollment, billing, and revenue cycle management. During this webinar, providers will understand CAQH, NPPES, I&A, Availity, ERA and EFTs, and Medicare portals.
Licensing and credentialing telehealth providers can pose challenges to expanding telehealth programs in rural communities. Licensing and credentialing are intended to protect patients by ensuring that telehealth providers are in compliance with state regulations and hospital policies. After COVID-19, there are many struggling hospitals, physician deficiencies, and insufficient access to healthcare providers. Many healthcare facilities invest more time, money, and resources into upgrading their telehealth offerings to neutralize these shortages.
Building a strong payor enrollment process for your Multi-location, Multi-Tax ID, and Multi-NPI healthcare systems is crucial. Yes, your complex multi-specialty organization needs you to manage every aspect of payor enrollment successfully. Credentialing and Enrollment Expert Yesenia will help you to determine if your organization is setup for network delegated agreements vs individual provider applications, and will also state by state licensure requirements.
Learning Objectives:
- Discuss credentialing & enrollment processes that impact your revenue cycle
- Assess structure needed to build a strong Payor Credentialing & Enrollment process
- Identify the data points that are needed for enrollment for remote practitioners
- Explain telemedicine standards across regulatory agencies and accrediting bodies
- Identify telemedicine credentialing challenges
- Learn strategies to more quickly onboard telemedicine providers
- Learn how to best Manage Payor Enrollments for the Multiple EINs, Multiple NPIs Healthcare Systems
Areas Covered in the Session:
- Payor Credentialing & Provider Enrollment
- Telehealth Enrollment
- Credentialing, Enrollment and Provider Account Management for Organizations with Payor “Delegated Agreements”
- Credentialing, Enrollment and Provider Account Management for Organizations that do not hold Payor “Delegated Agreements”
- Credentialing and Enrollment Process for Multiple Locations, Multiple NPIs, Multiple Tax IDs
- Current State Rules for Credentialing & Enrollment
- EFT & ERA
- CAQH
- NPPES
- PECOS
- Medicare
- Government Payors
- Commercial Payors
- Live Q&A Session
Suggested Attendees:
- Healthcare Providers, Practitioners
- Credentialing Specialist
- PESC
- Enrollment Specialist
- Revenue Cycle Team Members
- Revenue Cycle Managers
- Colleagues who Manage CAQH
- Colleagues who Manage NPI or NPPES
- Authorized Officials
- Delegated Officials
- Revenue Cycle Directors
- 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
- CNA’s
About the Presenter:
Yesenia Servin is an expert in credentialing and provider/ payor 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 payor enrollment structure. Thrives on training and growing administrative, credentialing and enrollment healthcare professionals.
Yesenia manages payor enrollment, keeps team members and colleagues up to date on industry trends, and is a liaison to all departments that impact payor-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.
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Email: care@skillacquire.com