National Provider Enrollment Forum 2019

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National Provider Enrollment Forum 2019

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National Provider Enrollment Forum 2019

February 25-28, 2019 | Las Vegas

Join top Medicare enrollment experts for four intensive days of hands-on enrollment training that solves real world enrollment problems.

Take the frustration out of enrolling and credentialing! Get step-by-step training and answers to your most pressing questions. Whether you work at a physician office, home health agency, hospital, rural health clinic or any other setting, this is the only training event that will help you master the enrollment process and ensure uninterrupted billing!

Connect with more healthcare leaders within the industry than ever before. You will have the chance to learn from the nation’s leading enrollment experts. We've also expanded the private payer presence and included credentialing information.

With four intensive days of hands-on training with our nationally-recognized experts, you’ll:

Get the first word on PECOS and NPPES updates and next generation applications that have been implemented due to input from participants at this event

  • Recognize the warning signs that may cause deactivation, revocation or denial to your organization’s enrollment 
  • Receive a plain-English walk through of the CAQH ProView application 
  • Get a side-by-side, field-by-field demonstration of how to fill out each 855 paper form and its online PECOS equivalent 

PLUS! Attend a preconference day tailored to beginners - get up-to-speed on the basics to prepare for the main conference!

This is your only chance to network with the nations top enrollment experts. They will provide you with real-life answers to your organization’s unique enrollment problems. You will have the opportunity to network with peers from other states and provider settings to discover tips and best practice strategies for efficiently managing enrollment and credentialing workloads! 


Dennis Grindle, CPADennis Grindle, CPA
Health Care Consulting Partne

Dennis K. Grindle, CPA, Partner in Health Care Consulting, has been with the consulting and accounting firm of Seim Johnson, LLP, since 1989 and prior to that time he had two years of tax consulting experience with a national accounting firm and four years of physician reimbursement management experience with a hospital-owned physician management group.

Dennis focuses on the following services: Medicare provider enrollment (Form CMS-855 completion and compliance consulting) issues; Medicare provider-based issues; Medicare reimbursement physician and non-physician practitioner Medicare billing issues, and other such issues.

Dennis has lectured on Medicare provider enrollment (Form CMS-855) issues, Medicare provider-based issues, physician and non-physician practitioner reimbursement matters, corporate compliance plans, physician compensation plans, and other practice management issues at a local, state and national level.

Dennis frequently does presentations on provider enrollment and reimbursement issues with representatives from the CMS Central Office, CMS Regional Offices, Medicare contractors, state agencies, and various other payors. He also serves on the CMS Central Office PECOS focus group and is a member of several professional and healthcare associations.

Gretchin S. Heckenlively, CPA, FHFMAGretchin S. Heckenlively, 

Health Care Consulting Partner

Gretchin is a CPA and Partner in Health Care Consulting division at Seim Johnson, LLP. She graduated from Doane College in May 1997 with a Bachelor of Science Degree in Accounting and Finance. Gretchin joined the firm in 1997 in the HealthCare Audit Division providing audit and Medicare/Medicaid cost report services on over 100 engagements. Gretchin left in 2006 to pursue an opportunity as the Chief Financial Officer of a critical access hospital. There she was able to gain valuable experience in both the financial and clinical arenas of a hospital.

Gretchin rejoined the firm in 2010 and since that time, she has been able to bring the knowledge and understanding of working in the healthcare environment to the consulting division. Gretchin’s focus since rejoining the firm has been on Medicare and Medicaid provider enrollment, Medicare provider-based issues and reimbursement.

Gretchin has given many presentations on a wide range of healthcare and not-for-profit related topics at a local, state and national level and is currently serves on the CMS Central Office PECOS focus group. In addition, she is an active member of Healthcare Financial Management Association (HFMA) and is a past President of the Nebraska Chapter. Currently, she is serving as the Treasurer of HFMA Region 8.

David Zetter, PHR, CHCC, CHCO, CPC, COC, PCS, FCS, CHBCDavid Zetter,

David is a consultant with Zetter Health Care Management Consultants. He has provided practice management, coding and compliance training to medical organizations for more than 25 years. David is also a nationally recognized enrollment expert and CMS regularly solicits his feedback in their PECOS user focus groups. David is a member of the Board of Directors for the National Society of Certified Health care Business Consultants and is a certified health care business consultant (CHBC). He is also a certified professional coder (CPC) for physician practices, hospitals and facilities, and a certified health care compliance consultant (CHCC).  David is also a member of the American Health Lawyers Association, the Medical Group Management Association and the Health care Financial Management Association.

**Agenda and Speakers Subject to Change**

Full Agenda

Preconference Agenda — Monday, February 25

12:00 p.m. – 1:00 p.m.

1:00 p.m. – 2:30 p.m.
Provider Enrollment 101
Gretchin Heckenlively
Jumpstart your mastery of Medicare enrollment as we untangle the web of CMS-855 forms and Medicare enrollment jargon. In this session you will learn:

  • Timelines, key definitions, available resources and organizational structures: Don’t know the difference between delegated official vs. authorized official? We’ll clarify more than 20 enrollment terms that are easily misunderstood. Plus, we’ll take you through ownership scenarios from sole proprietorships to corporations to illustrate the differences between eight business structures and all 40 certified provider and certified supplier types from FQHCs to HHAs that will impact what information is required on the CMS-855 forms.
  • Medicare enrollment in plain English — acronyms, applying for NPIs, PAR status: Learn how to stay afloat in the alphabet soup of acronyms as enrollment terms are translated into what they all mean and how and when they are important to you. Do you know what CORFs, EFTs, OPOs, NPIs, NPPES, and PTANs refer to? After this session, you’ll be singing the ABCs of enrollment and fully understand all the terminology like a pro.
  • Introduction to the CMS-855 forms: We’ll walk through all seven CMS-855 forms, give you insights on key differences and help you select the appropriate form to use.

2:30 p.m. – 2:45 p.m.
Refreshment Break

2:45 p.m. – 4:15 p.m.
Provider Enrollment 101 (continued)
Gretchin Heckenlively

4:15 p.m. – 4:30 p.m.

4:30 p.m. – 5:30 p.m.
PECOS Organizational Access for Beginners
Gretchin Heckenlively
Get a step-by-step walkthrough of the online PECOS enrollment process — from navigating NPPES to obtaining an NPI. Watch as our expert sets up physicians within PECOS using the very same steps you would.

5:30 p.m.
Preconference Adjourns

This program is pending approval by the National Association Medical Staff Services for [CE hours] continuing education unit(s).
Accreditation of this educational program in no way implies endorsement or sponsorship by NAMSS.


Agenda Day 1 — Tuesday, February 26

7:00 a.m. – 8:00 a.m.
Registration/Continental Breakfast

8:00 a.m. – 8:10 a.m.
Welcome and Announcements

8:10 a.m. – 10:30 a.m.
Enrollment Risks and Consequences — Steps in the Enrollment Process, Filing and Effective Date Considerations, Deactivation & More
Dennis Grindle and Gretchin Heckenlively
The Medicare enrollment process is more than completing some boxes on a form or in electronic data fields in the national PECOS database. This session highlights the compliance risks associated with completing the forms, the organizational structure of the provider or supplier, the disclosure requirements initially and ongoing, the impact on billing and cash flow, what resources are available to assist you through the process, the penalties for falsifying information and certification statements being attested to, just to name a few, so you avoid mistakes that can freeze payments for services you’ve already performed and succeed the first time you file your initial enrollment. Topics covered in this session include:

  • Timeframes for submission of CMS-855 forms
  • Reimbursement effective date dependencies for certified providers/suppliers
  • Effective date of billing privileges for physician/groups/NPPs

10:30 a.m. – 11:00 a.m.
Networking Break with Exhibitors

11:00 a.m. – 12:15 p.m.
David Zetter
Master the Identity & Access management system to request surrogacy on behalf of providers. Plus, we’ll clarify how Delegated Officials and Authorized Officials take on different meaning in performing enrollment vs. acting as a surrogate.

12:15 p.m. - 12:30 p.m.

12:30 p.m. – 1:30 p.m.
Networking Lunch with Exhibitors

1:30 p.m. - 2:15 p.m.
Panel Q&A: Studies
Dennis Grindle, Gretchin Heckenlively, and David Zetter
Join this professional development session featuring a moderated panel discussion about common problems and how to overcome them. Bring your own questions and find out how the speakers recommend handling issues such as how to handle an errant physician who falls through the cracks, to training surrogates, to staffing problems.

2:15 p.m. - 3:00 p.m.
Case Study: Building A Team
This professional development session focuses on common staff training and retention issues and best practices from successful organizations.

3:00 p.m. – 3:30 p.m.
Networking Break with Exhibitors and PECOS Station

3:30 p.m. – 5:00 p.m.
Provider-Based & §603 of the Bipartisan Budget Act of 2015 – Payment Reductions for Certain Off-Campus Hospital Departments
Dennis Grindle
Planning to relocate hospital outpatient departments? Be careful! With the passage of §603 of the Bipartisan Budget Act of 2015 on November 2, 2015, relocations of hospital outpatient departments from one address to another or the establishment of new off-campus provider-based hospital outpatient departments on or after November 2, 2015 could mean unintended payment reductions to your hospital. This was effective January 1, 2017 and continues through 2018. It’s determined by how you complete your Medicare enrollments. Remember, Medicare enrollment forms can impact how a provider/supplier is ultimately paid for its services.

5:00 p.m. – 6:00 p.m.
Networking Reception with Exhibitors

6:00 p.m.
Day 1 Adjourns


Agenda Day 2 — Wednesday, February 27

7:00 a.m. – 8:00 a.m.
Registration/Continental Breakfast with Exhibitors

8:00 a.m. – 10:15 a.m.
2019 Medicare Enrollment Regulations Updates
Dennis Grindle and Gretchin Heckenlively
Be the first to know of the latest changes and anticipated roll out of proposed Medicare enrollment forms, enrollment-tied Program Integrity Manual changes, unannounced site inspections and license verification, enrollment moratoriums and more. Plus, find out what’s next in CMS’s revalidation push and clarity on recent changes to enrollment processes (from Ordering & Referring to Surrogacy).

10:15 a.m. – 10:30 a.m.
Dennis Grindle and Gretchin Heckenlively

10:30 a.m. – 11:00 a.m.
Networking Break with Exhibitors and PECOS Station

11:00 a.m. - 11:45 a.m.
Medicare Revalidations
Gretchin Heckenlively
CMS is proposing new regulations that implement additional provider enrollment provisions of the Affordable Care Act to help make certain that entities and individuals who pose risks to the Medicare program and beneficiaries are kept out of or removed from Medicare for extended periods. Find out how to protect yourself from debilitating penalties caused by bad actors who compromise program integrity.

11:45 a.m. - 12:15 p.m.
Dennis Grindle and Gretchin Heckenlively

2:15 p.m. – 1:15 p.m.
Networking Lunch with Exhibitors

1:15 p.m. – 2:30 p.m.
Hidden Compliance Risks within the Medicare Billing Privilege Process
Dennis Grindle
Enrollment and billing are more closely connected than you might think! Dennis explains exactly how the two are related and offers best-practice sleuthing tips that will keep your practice safe from surprising and costly vulnerabilities and liabilities and ensure you remain 100% compliant. Areas of risks covered in the session include: Reassignment rules, “Incident to” rule, Carrier Jurisdiction rules, Site-of-Service rules, Three Day Payment Window rules.

2:30 p.m. - 3:00 p.m.
Dennis Grindle and Gretchin Heckenlively

3:00 p.m. – 3:30 p.m.
Networking Break with Exhibitors and PECOS Station

3:30 p.m. – 5:30 p.m.
How to Complete the CMS-855B
Dennis Grindle and Gretchin Heckenlively
Enroll or revalidate completely, accurately and efficiently as Dennis thoroughly explains each of the 17 sections of the CMS-855B form, pointing out common errors to avoid and clarifying what's being asked, including:

  • Practice location information
  • Organizational and individual control sections
  • Billing agency information
  • Special requirements section
  • Statements, attestations & supporting document requirements

5:30 p.m.
Day 2 Adjourns


Agenda Day 3 — Thursday, February 28

7:00 a.m. – 8:00 a.m.
Continental Breakfast with Exhibitors

8:00 a.m. – 9:30 a.m.
How to Complete the CMS-855I
Dennis Grindle and Gretchin Heckenlively
Physicians, physician assistants, physical therapists and other NPPs will discover how to successfully complete each required section of the 28-page CMS-855I and the many screens within the PECOS equivalent online enrollment process. You’ll learn how to complete when using moonlighting residents, how to complete to reactivate a practitioner’s enrollment, to revalidate or change information and much more.

9:30 a.m. - 10:00 a.m.
How to Complete the CMS-855R for Reassignment of Medicare Benefits
Gretchin Heckenlively
Learn how to complete the new CMS-855R that was required for use on June 1, 2016.

10:00 a.m. – 10:30 a.m.
Networking Break with Exhibitors and PECOS Station

10:30 a.m. – 11:30 a.m.
How to Complete the CMS-855A
Dennis Grindle and Gretchin Heckenlively
Learn which providers are required to complete the CMS‐855A and the information that must be included on the form.

11:30 a.m. – 12:00 p.m.
How to Complete the CMS-855S for DME Suppliers
Dennis Grindle and Gretchin Heckenlively
Apply what you’ve learned thus far about acronyms, definitions and more to ensure quick and speedy completion of sections in the 38-page CMS-855S application appropriate for your organization, plus view the corresponding online PECOS pages.

12:00 p.m.
Conference Adjourns

**Agenda and Speakers Subject to Change**

Conference Location

MGM Grand Hotel, Las Vegas

Stay at the iconic MGM Grand in Las Vegas, a sprawling casino resort located on the South end of the Strip. Enjoy world-class amenities such as 4 pools, 3 whirlpools, and a lazy river, as well as a spa and fitness center. There's a 24/7 casino, live entertainment and trendy nightclubs, in addition to multiple fine dining and casual restaurants.

Special Conference Room Rates
$185/night (+ $37 daily resort fee) through Monday, February 4, 2019
MGM Grand Hotel
3799 Las Vegas Boulevard South
Las Vegas, NV 89109

Check-In: 3:00 p.m.
Check-Out: 12:00 p.m.
Phone: (877) 880-0880

Reserve your room online or contact the hotel directly at (877) 880-0880 and reference DecisionHealth National Provider Enrollment to take advantage of discounted rates. To receive the discounted rate, reservations must be made by Monday, February 4, 2019. Thereafter, reservations will be taken on a space and availability.


Main Conference


All-Access Pass

Main Conference Materials
Electronic conference materials and the CMS Forms Book are included with your registration and can be obtained in the Download Center. Printed materials are not available for purchase online or onsite after January 18.

Multiple Attendees?
Send your team of three or more and save an additional 10%! Your savings will automatically calculate in your cart when you register. Prefer to register by phone? Contact John Prentice 1-855-225-5341 x6056 or

Call our customer service team at 855-255-5341 or email

Cancellation Policy
Due to the nature of live events – the need for advance purchases and limited seating - full refunds are not offered. However, we do offer the following:

Cancellations received 30 days or more prior to the event are eligible for a credit or refund, less a $250 cancellation fee. The credit will be valid for up to 90 days from date of cancellation.
Cancellations made 30 to 14 days prior to the event are not eligible for refunds but are eligible for payment transfer (credit) to another H3.Group event, less a $250 cancellation fee. The credit will be valid for up to 90 days from date of cancellation.
Registrants(s) who cancel less than 14 days prior to the event will be considered "no shows" and will not be eligible for refunds/credits.
Registrants who do not cancel and do not attend are liable for the full registration fee.
Please notify the conference registrar at 1-800-650-6787 with any requests for changes.

H3.Group is not responsible for any loss or damage as a result of a substitution, alteration or cancellation/postponement of an event. H3.Group shall assume no liability whatsoever in the event this conference is cancelled, rescheduled or postponed due to an unfortunate event, Act of God, unforeseen occurrence or any other event that renders performance of this conference impracticable, illegal or impossible. For purposes of this clause, an unfortunate event shall include, but not be limited to: war, fire, labor strike, extreme weather or other emergency.

**This policy is subject to change.**

Continuing Education


This program has the prior approval of AAPC for 16.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.