5-Part Series: Stop Medicare Enrollment & Credentialing Chaos

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Part 1: Credentialing 101: Proven Tactics Keep Practice Revenue Flowing

Credentialing and enrollment 101 for physician practices. Step-by-step strategies to help you master credentialing and enrollment basics to avoid errors and ensure that your revenue keeps flowing.

Part 2: Speed Up Credentialing & Reimbursement for New Providers

Onboarding a new physician quickly and correctly is essential to making the most of new revenue opportunities. Time new credentialing, Medicare enrollment, hospital privileges, and more for accurate, on-time billing.

Part 3: PECOS: Master CMS Surrogacy Enrollment Requirements

Using your provider’s login to manage Medicare enrollment violates CMS rules. Enrollment expert, David J. Zetter, provides practical tactics to help you comply with CMS requirements for PECOS surrogacy management.

Part 4: Get Medicare Enrollment (855I/855R) Approvals & Payments Fast

Overcome complexities in Medicare provider enrollment when adding, reassigning, and terminating providers. Step-by-step strategies for CMS Forms 855I & 855R to get faster approvals & speed reimbursement.

Part 5: Stop Provider Credentialing Headaches w/Proven Tracking Tools

The physician credentialing process is a complicated collection of hoops to jump through and moving parts to track. Get a step-by-step, proven process to help you keep cash flowing.

Getting your providers enrolled in Medicare and making sure that their credentialing is managed accurately and on time can be a massive headache.

It almost seems like Medicare makes provider enrollment and credentialing as confusing as possible with numerous deadlines, online login requirements (PECOS, NPPES), slow new provider approval, application changes (forms 855I/855R), numerous notifications, multiple account types (surrogacy, I&A), etc. etc. etc. Well, the good news is that it doesn’t have to be confusing.

This recently released training 5-Part Series: Stop Medicare Enrollment & Credentialing Chaos offers step-by-step advice from three national experts

  • David J. Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP
  • Dreama Sloan-Kelly, MD, CCS, CPC
  • Tracey Tokheim.

Each session in this practical series tackles one piece of the Medicare enrollment and credentialing process. Then, the experts provide you with easy-to-implement, actionable advice to make the processes more manageable. After going through all 5 parts of the training, you’ll have a solid foundation, along with expert tactics, to make enrollment and credentialing for Medicare providers faster, easier, and more accurate.

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PART 1: Credentialing 101: Proven Tactics Keep Practice Revenue Flowing

Order the On-Demand Recording to Watch at Your Convenience.

The consequences of incorrect provider enrollment and credentialing are extreme. Your provider can be terminated from payer networks, lose hospital admitting privileges, and see dramatic reductions in new patients and revenue.
Sure, much regarding provider credentialing isn’t rocket science, but there are specific nuances that can trip you up and lead to serious reimbursement backlash. However, with a little guidance, you could avoid these devastating revenue delays due to credentialing errors and ensure that your revenue keeps flowing.

That’s where credentialing and enrollment expert, Tracey Tokheim, can help. During her 90-minute online training session, she’ll walk you through the most important aspects of provider credentialing and enrollment, and help you ensure everything sails through the approval process the first time.


PART 2: Speed Up Credentialing & Reimbursement for New Providers

Order the On-Demand Recording to Watch at Your Convenience.

When onboarding a new physician to your practice, your process must be flawless. The slightest mistake can result in significant reimbursement delays – or worse, payer rule violations.

To get your new provider up to speed fast, there are a million details you must get right the first time. Failure to do so can significantly delay a new provider from being eligible to see patients and get paid. Even simple errors can get your set-up/transfer documents thrown out, and then you have 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. You can make this happen by attending this online training presented by practice management expert, David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP.

David 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. David’s upcoming online training will give you the proven tactics you need to make this happen.


PART 3: PECOS: Master CMS Surrogacy Enrollment Requirements

Order the On-Demand Recording to Watch at Your Convenience.

CMS specifically prohibits you from using your provider’s PECOS (Provider Enrollment, Chain and Ownership System) login to manage, verify, update or authorize their Medicare enrollments.

Instead, the Agency wants you to set up a PECOS Surrogacy enrollment account which allows you to work on your provider’s behalf using your own login. Failing to comply with these rules, means that you are NOT in compliance with CMS requirements – not somewhere you want to be.

There are strict guidelines for proper completion and compliance for managing Medicare PECOS surrogacy enrollment accounts, which means the accurate set-up of connection requests and access can be complex and confusing.

This is where enrollment expert and educator, David J. Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, can help. During his 60-minute online training, David will walk you through how to set up your Identity & Access Management System (I&A) and Surrogacy accounts, so you get it right the first time. You’ll get step-by-step advice on how to set up connection requests that allow you to access multiple systems (PECOS, NPPES, & NPI). Also, you’ll receive instruction on how to utilize the multifactor authentication process.


PART 4: Speed Medicare Enrollment (855I/855R) Approval & Payments

Order the On-Demand Recording to Watch at Your Convenience.

You have no choice. You must complete your Medicare provider enrollment forms 855I and 855R correctly, down to the letter, the first time, or risk not being paid.

Whether you use PECOS (Provider Enrollment, Chain, and Ownership System) or submit your Medicare provider enrollment forms manually, missing even one small step can have disastrous consequences for BOTH your new and existing providers. This is especially important considering the recent changes to the PECOS submission process.

Even a small blunder can bring your Medicare reimbursement to a halt – or worse, result in your providers not being able to see Medicare patients at all. Side-stepping the commonplace pitfalls that occur during the complex Medicare provider enrollment process is not easy. However, it is necessary if you want to get your new providers approved quickly and maintain your existing providers’ ability to be reimbursed by Medicare.

Fortunately, you don’t have to figure this out on your own…

This is where enrollment expert, Dreama Sloan-Kelly, MD, CCS, CPC, can help. During this online training session, Dr. Sloan-Kelly walk you through each part of the PECOS-driven CMS Forms 855I and 855R step-by-step. In only 60 minutes, you’ll receive proven strategies to ensure you get it right the first time.


PART 5: Stop Provider Credentialing Headaches w/Proven Tracking Tools

Order the On-Demand Recording to Watch at Your Convenience.

Your providers are depending on you to accurately manage their credentialing and enrollment obligations. If something falls through the cracks, or if the information is not 100% accurate, your physicians can be left with no way to get paid.

Whether you are managing payer credentialing requests, updating hospital applications or adding a new provider, there are a million places where things can go wrong. Every payer, hospital, and government agency has their own unique requirements, and without the right monitoring tools, it can seem impossible to stay ahead.

Fortunately, credentialing expert, David Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, can help. During this online training, David will walk you through each step of a successful credentialing and enrollment management process. Whether you are managing one or 100 providers, he’ll help you determine how you can streamline your current monitoring processes to reduce your hassle and improve the outcomes.


Past Webinar Reviews:

This was a great, basic training guide for new credentialing and provider enrollment personnel who are unfamiliar with CMSI & A, PECCOS, and NPPES.”
– Marilla Knight, Emergence Health Network

“The content was well organized. Ms. Tokheim was knowledgeable about the different aspects of credentialing.”
– Monica Martin, Central Nephrology Clinic

“The webinar was very thorough and explained the information well. The speaker did a great job teaching the subject.”
– Joan Taylor, Callender Dermatology and Cosmetic Center

“The overall experience was seamless. It was helpful to have the handouts ahead of time. The presenter was engaging, knowledgeable, and articulate.”
– Bridget Coleman

“I thought the webinar was great especially since I am new to credentialing.”
– Kristine Keane, Shore Neuropsychology & Behavioral Health

“Very informative. Great job breaking down the information!”
– Angie Young, Ferrell Hospital


100% Satisfaction Guaranteed or a Full Refund. 

You take no risk whatsoever. If you find this essential session doesn’t meet your expectations or you are not satisfied for any reason, simply let us know.

Meet Your Experts

Tracey TokheimAperture Credentialing, LLC

A recognized leader known for crafting strategic vision to achieve business goals through the development and execution of process efficiency, out-of-the box thinking, and key management partnerships.

While serving as a Product Line Senior Director with Aperture Credentialing, LLC, Tracey has achieved a strong customer collaboration to secure customer commitment to efficient provider enrollment/credentialing and the use of our products to get to a very efficient process.

Tracey’s career is comprised of over fifteen years management experience and over ten years project management execution while being recognized by staff for exceptional customer focus and employee recognition opportunity as “One of our Best” nominated by employees and leaders.

Tracey has dedicated her adult career to health care organizations experiencing process failure and been a part of achieving process success, execution successful implementation of training and process change, and leaves a mark as a leader by example.

Tracey holds a Master’s in Business Administration and Project Management and donates time and dollars to help children play sports who otherwise cannot afford it.    She also has a passion for the outdoors while spending time with family and on her Harley.  Tracey lives in Minnesota hence being outdoors is a love and a must.  Even in the cold!!!

David J. Zetter
PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHPFounder & President, Zetter Healthcare Management Consultants

David Zetter is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 30 years of operational and healthcare experience.

Many recognize David nationally for his presentations and expertise. He excels in revenue cycle management, credentialing and contracting, compliance, coding and documentation. People see David as 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, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. David Zetter’s activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types. This includes 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. This gave David the knowledge of what the expectations are from the payers.

David’s firm works with healthcare professional clients and facilities coast to coast. Zetter’s specialties include all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, and governance documentation. Zetter’s firm may also assist you in policies and procedures, credentialing and contracting, HR management, compliance, chart reviews, and more.

David has helped to maximize both profitability and reimbursement of physician practices, facility, and ambulatory practices. He also re‐engineered operational and human resources, addressing coding and billing issues for providers to curtail fraud, OIG, and IRS issues.

 Engagements and Associations

He is also an original member of CMS’ PECOS Power User Group, CMS Compliance Focus Group and MIPS Design Lean Work Group. This group provides feedback to Medicare’s Center for Program Integrity and Provider Enrollment Operations Group on design and improvements to the PECOS enrollment environment. It also provides feedback for NPPES and MIPS and beta tests the EHR/HITECH user interfaces. 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, HR, coding, and compliance education and seminars in many states over the past twenty‐five years. He speaks often on a variety of practice management subjects at hospital residency programs. This includes the NSCHBC, MGMA, AAPC, AHIMA, Florida Institute of Certified Public Accountants, Florida Medical Society, and many other venues. David Zetter works with MGMA, HFMA, Decision Health, Part B News, and Part B Insider to conduct audio conferences and webinars. He is published in Medical Economics and interviewed in publications including Report on Patient Privacy and Report on Medicare Compliance.

David is the current President and Executive Board Member of the National Society of Certified Healthcare Business Consultants. He has served on the Education Committee for more than fifteen years and is a Certified Healthcare Business Consultant. David is a member of the Society for Human Resource Management and former Professional Development Chair/ Vice President of Human Resource Professionals of Central PA. David is a former board member of the Central PA affiliate chapter of the AAPC and is certified as a Professional Coder for physician practices, hospitals and facilities. Additionally, he is also a Certified Compliance Consultant and Officer. Zetter is a member of the AHLA, the MGMA and the HFMA.

Dreama Sloan-Kelly
MD, CCS, CPCCEO of Kelly, Sloan and Associates, LLC

Dreama Sloan-Kelly, MD, CCS, CPC has over 14 years of experience in the medical field. A graduate of Wellesley College and Tufts University School of Medicine she has a varied background including clinical, billing, and coding. As CEO of Dr. Sloan-Kelly Consulting, Dreama speaks at various seminars, imparting her knowledge in an upbeat, matter of fact, manner.

Her goal is get the pertinent information to the attendee, minimize the nonsense, and make sure everyone has fun at the same time. Dreama works with practices one on one, through coding consulting. She offers in-services seminars that can be held on or off-site. Dreama has learned in most seminars you spend a whole day only getting 20% of what you need, and 80% you leave – she has made it her goal to carve out the 20% that you need and giving you the take home message that will help you and your practice.