Credentialing Resource Center Virtual Event Rebroadcast

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Credentialing Resource Center Virtual Event Rebroadcast

Product Code: CRCV100620--

Credentialing Resource Center Virtual Event Rebroadcast

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Credentialing Resource Center Virtual Event Rebroadcast

October 6-8, 2020

Some things are too good not to share, and that is why we are releasing the Credentialing Resource Center Virtual Event Rebroadcast.

After three days of insightful, engaging, and inspiring discussion we realized the knowledge provided at the live event was too valuable to stop sharing. The live-rebroadcasted event will allow you to carve out the time and commit to three days of learning, growth, and professional development in a structured and concrete format.

The Credentialing Resource Center Virtual Event Rebroadcast allows you to earn valuable CEUs and receive access to the great educational content you’ve come to expect from Credentialing Resource Center. Engage in education and training for MSPs, medical staff leaders, and quality directors in credentialing environments spanning the care continuum. Top industry experts impart fresh insight and actionable strategies for developing and sustaining effective credentialing, privileging, competence assessment, and medical staff governance processes amid constant changes to healthcare service delivery and reimbursement.

Whether you’re a newly minted professional or an industry veteran, you won’t want to miss the rebroadcast of this special virtual event. The speaker lineup features celebrated experts and in-the-trenches MSPs and medical staff leaders eager to share their success stories and practical application pointers.

Provider Enrollment Virtual Summit

Tuesday, September 29 – Thursday, October 1, 2020

Connect with industry experts and provider enrollment specialists around the country at the Provider Enrollment Virtual Summit!

Join us for an innovative virtual event featuring engaging education and training for provider enrollment professionals, enrollment managers, and credentialing specialists. Ideal for both new and experienced enrollment professionals, this event is your opportunity to get step-by-step training and answers to your most pressing questions as you master the enrollment process.

You can listen live to the programs during the virtual event from September 29 to October 1 and participate in daily Q&As with our experts. Or choose to play the sessions at a later date that works best with your schedule: Once registered, you’ll have access to all educational sessions for 60 days.

Our expert speakers are industry veterans and offer best practices for developing and sustaining successful enrollment processes. Join us to earn valuable CEUs, participate in educational sessions, ask questions of our speakers, and network with your colleagues and peers—all from an easy-to-use conference platform, accessible via your computer or your mobile device!

Plus, when you register for this event, you will receive complimentary access for the Provider Enrollment Specialist Certificate exam. Demonstrate your mastery of the provider enrollment process and prove that you have the expertise required to ensure prompt enrollment by earning the PESC! Click here for more information about this exciting certificate. 

Fundamentals of Provider Enrollment – a Bonus Learning Opportunity for Attendees!

Session 1: Introduction to Provider Enrollment
Terri Lynn Davis, BS-HCA
Join Terri Lynn Davis for a foundational session on provider enrollment, perfect for those who are new to the enrollment field and those who are looking to brush up on the basics. Davis defines key industry terminology, outlines the differing purposes of various CMS enrollment forms, and explains in simple steps how to successfully enroll providers.

Session 2: Exploring PECOS, Identity & Access, and Surrogacy
Join David Zetter for an introduction to the Provider Enrollment, Chain, and Ownership System (PECOS). Learn the key functions of the Identity & Access Management System (I&A), the National Plan & Provider Enumeration System (NPPES), and National Provider Identifiers (NPI).

Session 3: Understanding the Relationship Between Credentialing and Provider Enrollment
Terri Lynn Davis, BS, HCA
Credentialing and provider enrollment have more in common than many realize, and in this session, Davis explains where these overlaps exist and outlines how both industries require similar skills. She also describes the primary functions of both departments, including primary source verification and the enrollment process. 



Day 1 

1 Hour 

Keynote: The Many Faces of Problem Practitioners

Presented by: Todd Sagin, MD, JD

Our faculty kick off the 2020 CRC Symposium with a deep dive into the case of ex-neurosurgeon Christopher Duntsch, also known as Dr. Death. Learn about the failures and shortcomings in the credentialing, privileging, and peer review processes that allowed Duntsch to continue to practice medicine after maiming and even killing patients. Our faculty will also review other recent, ripped-from-the-headlines cases, which will prepare us to begin our discussion on “the many faces of problem practitioners.”

1 Hour

Fundamentals of Credentialing

Presented by: Carol S. Cairns, CPMSM, CPCS; Amy M. Niehaus, CPMSM, CPCS, MBA

Credentialing is intended to be the first line of defense in keeping out problematic practitioners. However, a recent study found that 85% of practitioners who went through the corrective action process should never have made it through the initial credentialing process. Join our speakers for a back to basics credentialing session on the leading best practices in credentialing, primary source verification, and communicating with applicants.

1 Hour

Peer Review 2020: A Practical Strategy for Navigating Murky Waters

Presented by: Jeffrey Sanfield, MD

Walk away from this session with a practical way to incorporate effective peer review in your organization. Attendees will learn the challenges of objectively managing peer review, several ways to manage conflicts of interest and barriers to success, how to find a balance between support and discipline, and how to create an objective algorithm and policy on medical staff professional practice evaluation.

1 Hour 

Collaborative Approach to Developing and Maintaining Delineation of Privileges in Your Organization

Presented by: Janet Wilson, BS, CPMSM, CPCS, FMSP

With advances in healthcare and technology, organizations must be diligent in the development and maintenance of delineation of privilege forms. Not only do accrediting and regulatory bodies require current privilege forms and criteria, organizations have an obligation to their patients to ensure practitioners are practicing within the scope of the services defined by the organization’s governing body. During this presentation, attendees will learn the importance of developing and reviewing privilege forms, as well as ideas for an ongoing, systematic, collaborative approach to privilege form maintenance.

30 Minutes

Recorded Q&A Session

(Todd Sagin, Janet Wilson, Jeff Sanfield)



Day 2 

1 Hour  

The Growing Threat of Negligent Credentialing Litigation

Presented by: Carol S. Cairns, CPMSM, CPCS; Todd Sagin, MD, JD

Today, it seems like there are more negligent credentialing lawsuits than ever before. This session will explain the nature of negligent credentialing lawsuits and explore the forces driving their sudden proliferation. Our speakers will also share insights based on their own experiences with negligent credentialing cases. Learn how to develop solid policies and gain tips for identifying common triggers so that your organization can avoid negligent credentialing lawsuits.

1 Hour

Case Review: Getting It Right

Presented by: Mark A. Smith, MD, MBA, FACS; Todd Sagin, MD, JD

Although peer review is more than just case review, case review is still the foundation for much of peer review. However, medical staffs still struggle to establish a well-defined, well-documented process built on sound principles to reduce bias. This session will focus on how to conduct case review so that it is effective, avoids physician hostility and politics, and is seen as objective and fair.

1 Hour

Preventing Credentialing Mishaps Through Integration

Presented by: Amy M. Niehaus, CPMSM, CPCS, MBA

Are there ways to prevent problematic practitioners from joining your organization even before the credentialing process? This session will explore ways to vet practitioners earlier in the process, such as during the recruiting, interviewing, and hiring processes, and help you determine what information you can collect before offering a practitioner an application/contract.

1 Hour

Current Trends in OPPE and FPPE

Presented by: Mark A. Smith, MD, MBA, FACS

Peer review veteran Mark Smith will look at changes and new trends in the OPPE and FPPE realm, such as applying peer review across a healthcare system, OPPE vs. case review, increases in Joint Commission citations, and how value-based medicine is affecting OPPE and FPPE.

30 Minutes

Recorded Q&A Session

(Mark Smith, Amy Niehaus)



Day 3 

1 Hour

Developing a New Provider Orientation Program

Presented by: Barbara Warstler, MBA, CPMSM, FASPR

This interactive session will give participants practical tools and examples to help new providers get started on the right foot. You will learn why having an orientation program is important, review the cost of provider turnover to an organization, how to develop an orientation program, and how to conduct follow-up with providers after orientation. 

1 Hour

CVO vs. MSO Zones: Where Does One Stop and the Other Begin?

Presented by: Christine Bergeron; Jennifer Cloud, CPCS, CPMSM

There is no shortage of work involved in verifying, onboarding, and enrolling providers. But ironically, there are common zones of duplication when a CVO or delegated credentialing arrangement is used. During this session, participants will learn how to bridge the gap between the CVO team and their internal customers (medical staff office) and external customers (insurance payers) in ways that lead to efficiencies and cost savings, ultimately setting the organization up to become automated.

1 Hour

Advanced Practice Professionals: Expanding Their Scope of Practice

Presented by: Carol S. Cairns, CPMSM, CPCS

What do you do when an APP wants to expand their scope of practice? What do you do when you learn an APP is practicing outside of their scope? What if the scope is not well-defined or the supervising physician is not properly identified? Attendees will learn about a recent court case in which all of these issues occurred and what they can do to create a mechanism that supports legal expansion of an APP’s scope of practice.

1 Hour

Medical Staff Applications: Pink Flags vs. Red Flags

Presented by: Carol S. Cairns, CPMSM, CPCS; Mark A. Smith, MD, MBA, FACS

Without thorough and comprehensive credentialing processes, medical staff leaders and MSPs may inadvertently allow undesirable practitioners to be granted clinical privileges. During this session, attendees will learn how to identify, investigate, and report subtle “pink flags” on medical staff applications in order to keep patients safe and reduce medical and legal risk to the organization.

30 Minutes

Recorded Q&A Session

(Carol Cairns, Barbara Warstler, Christine Bergeron & Jennifer Cloud)



Carol S. Cairns

Carol S. Cairns, CPMSM, CPCS, has more than 40 years of experience in the medical staff services profession. She is the president of PRO-CON, and an advisory consultant and frequent presenter with The Greeley Company. A recognized expert in the field, Cairns has been a faculty member with the National Association Medical Staff Services (NAMSS) since 1990. She presents frequently at state and national seminars on subjects such as basic and advanced credentialing and privileging, core privileging, AHP credentialing, CMS’ Conditions of Participation, and the standards of-and survey preparation for-The Joint Commission, NCQA, HFAP, and DNV GL. For the past 18 years, Cairns has been an advisor to healthcare attorneys, including providing expert witness testimony regarding credentialing and privileging issues. She conceptualized and wrote six versions of Verify and Comply, an industry textbook and favorite since 1999.

Amy M. Niehaus

Amy M. Niehaus, CPMSM, CPCS, MBA, is an independent healthcare consultant with more than 25 years of experience in the medical services and credentialing profession. In her current role, she advises clients in the areas of accreditation, regulatory compliance, credentialing, process simplification and redesign, credentialing technology, credentials verification organization (CVO) development, and delegation. Niehaus has worked in multiple environments throughout her career, including acute care hospitals, CVOs, managed care organizations (MCO), health plans, and consulting firms. She has been a member of NAMSS since 1991, is currently a NAMSS instructor, and previously served as chair of the association’s MCO Task Force, and chair and member of the NAMSS Education Committee. She is a former president of the Missouri Association Medical Staff Services and its Greater St. Louis Area chapter. Niehaus frequently speaks on credentialing and privileging processes; TJC, NCQA, and URAC accreditation standards and survey preparation; CVO certification; provider enrollment; and delegation. She has authored and contributed to a variety of industry-related publications and is the author of Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs, and Delegated Entities (HCPro, 2019).

Todd Sagin, MD, JD

Todd Sagin, MD, JD, is a physician executive recognized across the nation for his work with hospital boards, medical staffs, and physician organizations. He is the national medical director of Sagin Healthcare Consulting, LLC, and HG Healthcare Consultants, LLC, which provide guidance on a wide range of healthcare issues. He served for more than half a decade as the vice president and national medical director of The Greeley Company. Sagin is a practicing family physician and geriatrician who has held executive positions in academic and community hospitals and in organized medicine. He frequently lectures and facilitates retreats on medical staff affairs, physician leadership skills, relationships between hospitals and doctors, strategic healthcare planning, governance, and related topics.

Mark A. Smith, MD, MBA, FACS

Mark A. Smith, MD, MBA, FACS, is an independent senior healthcare consultant with HG Healthcare Associates. He previously served as the chief medical officer with Morrisey Associates Inc./Morcare LLC. Smith brings 30 years of clinical practice and hospital management experience to his work with physicians and hospitals across the United States. For the past 12 years, he has practiced as a clinical assistant professor of surgery in the Vascular and Endovascular Surgery Section at the University of California, Irvine Medical Center. Smith’s clinical practice as a surgeon and multiple roles in senior hospital administration make him uniquely qualified to assist clients develop solutions to their complex problems, including system quality and performance improvement, peer review, ongoing and focused professional practice evaluation, management of deficient practitioner performance, criteria-based privileging, low volume practitioners, ED call and external focused review. Smith is a board-certified vascular surgeon. He previously practiced general and vascular surgery in a private practice setting for 25 years. Smith’s previous positions include president of the medical staff, chief of surgery, chair of peer review committee, medical director of cardiac surgery at Desert Regional Medical Center and chief medical officer for the Verisys Corporation.

Christine Bergeron

Christine Bergeron is the CVO client liaison and operations director at symplrCVO, the NCQA-certified credentials verification organization that works with hospitals, health systems, payors, accountable care organizations, and other facility types to provide fast, expert provider credentialing and payor enrollment. Bergeron joined IntelliSoft Group in November 2010 as provider enrollment team lead for IntelliCVO—the precursor to symplrCVO—where she managed the activities of a telecommuting provider enrollment team and established key productivity metrics that helped the CVO lead the market. Previously, Bergeron was a senior analyst at Cambron Credentials from 2007 to 2010, where she provided primary source verification and payor enrollment services. Bergeron studied accounting at Champlain College in Burlington, Vermont. She enjoys using her skills and vast experience interacting with prospective and current primary source customers and payor enrollment customers to guide them in all stages of projects.

Jennifer Cloud, CPMSM, CPCS

Jennifer Cloud, CPMSM, CPCS, is the director of provider credentialing services at symplrCVO, the NCQA-certified credentials verification organization that works with hospitals, health systems, payors, accountable care organizations, and other facility types to provide fast, expert provider credentialing and payor enrollment. She oversees a team of payor enrollment specialists, CVO credentialing specialists, and managers in the division. Cloud joined IntelliSoft Group in October 2016 as a provider enrollment specialist for IntelliCVO—the precursor to symplrCVO—and was quickly promoted to manager of provider enrollment in November 2017. She and her team work collaboratively with the operations, sales, and marketing teams, as well as the executive staff, to exceed symplrCVO customers’ needs and expectations. Previously, Cloud was manager of medical staff services for LRG Healthcare from October 2012 to October 2016. Cloud earned her certified provider credentialing specialist credential in 2009 and her certified professional medical services management credential in 2011 and had the privilege to serve as President-Elect of New Hampshire Association Medical Staff Services.

Jeffrey A. Sanfield, MD, FACP, CDE

Jeffrey A. Sanfield, MD, FACP, CDE, is a practicing physician and experienced medical staff leader based in Michigan. He has been chair of the internal medicine department at St. Joseph Mercy Hospital in Ann Arbor Michigan since 1998, chair of the credentials committee at St. Joseph Mercy Health Systems in Ypsilanti, Michigan, since 2007, and chair of the allied health credentials committee since 2007. He has held numerous other medical staff leadership positions throughout his medical career and has consulted and been involved in many quality assurance and peer review activities. Sanfield is the president and founder of Ann Arbor Endocrinology and Metabolism P.C. and is the medical director of the Diabetes and Endocrinology Division of St. Joseph Mercy Hospital. He is board certified in internal medicine, endocrinology and metabolism, and is a certified diabetes educator. Having received many honors and awards over the years, Sanfield has been named “Top Doc” by Hour Magazine more than ten times and voted as a “Top Doctor in America” by Consumer Checkbook, both of which speak to his passion for his patients.

Barbara Warstler, MBA, CPMSM, FASPR

Barbara Warstler, MBA, CPMSM, FASPR, is associate vice president of client relations for The Hardenbergh Group in Livonia, Michigan. Warstler brings 20 years of credentialing, medical education, physician relations, and physician recruitment experience to her role working with hospital administrators, medical staff leaders, and medical services professionals in hospitals, health systems, CVOs, health plans, medical groups, and networks across the United States. In her current role, Warstler identifies experienced, qualified MSPs to help clients fill temporary vacancies, supplement existing staff during peak workloads, assess and improve operational efficiency, prepare for upcoming regulatory surveys and audits, pursue National Committee for Quality Assurance accreditation and certification, and more. Warstler is a thought leader, having authored numerous articles and spoken frequently around the country. Prior to joining The Hardenbergh Group, Warstler was the director of medical staff services, credentialing and provider enrollment, for the University Hospitals Health System in Cleveland, Ohio. Warstler is a certified Fellow in the Association for Advancing Physician and Provider Recruitment, maintains her Certified Professional Medical Services Management (CPMSM) status, is certified in Lean-Six Sigma, and, in 2018, received the Credentialing Resource Center Collaboration Award. Warstler earned her Master of Business Administration degree, specializing in Human Resources from Ashland University

Janet Wilson, CPMSM, CPCS

Janet Wilson, CPMSM, CPCS, has been involved in the medical staff services, quality, and credentialing industry for the past 30 years. Her healthcare experience extends to hospitals, quality, managed care, and the CVO environment. Wilson is currently the Central Texas Division Director of Medical Staff Affairs and CVO of Baylor Scott & White Health. Wilson holds a Bachelor of Science in Health Administration and is CPMSM and CPCS certified by NAMSS. Wilson served for three years on the board of directors of NAMSS. Wilson also served on the board of directors of the Texas Society of Medical Staff Services and served as president during her tenure on the board. Wilson has also been an independent educator and consultant  for over 14 years in the areas of credentialing, CVO, quality and medical staff services, with a primary focus on bylaws revisions, privilege form development, medical staff leadership education programs, and development and standardization of policies and procedures/documents across multiple hospital settings. Wilson has taught onsite and virtual CPMSM/CPCS certification study groups and professional development courses for over 14 years. In 2012, Wilson developed and launched a Certification Focused Study Program and teaches the Certification Program exclusively for EDGE-U-CATE, LLC., and is member of their faculty. She also assists in teaching EDGE-U-CATE’s Credentialing School.

Continuing Education

Accreditation Council for Continuing Medical Education (ACCME)
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 13.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity

National Association Medical Staff Services (NAMSS)
This program has been approved by the National Association Medical Staff Services for 12 continuing education unit(s). Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS.