National Provider Enrollment Forum 2020

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National Provider Enrollment Forum 2020

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National Provider Enrollment Forum 2020

April 19-22, 2020 | New Orleans

Master the enrollment process at the 2020 National Provider Enrollment Forum, the leading professional event for provider enrollment specialists!

The 2020 National Provider Enrollment Forum delivers two and a half days of engaging education and training to credentialing specialists, provider enrollment professionals, and enrollment managers. Experienced veterans in the field as well as top industry experts offer best practices and tips for developing and sustaining successful enrollment processes. Whether a newly minted professional or an experienced enrollment specialist, you won’t want to miss this opportunity to get step-by-step training and answers to your most pressing questions!

Co-located with the Credentialing Resource Center Symposium in the incredible city of New Orleans, the 2020 National Provider Enrollment Forum is bursting with innovative speakers, fresh insights, and brand-new sessions!

Hot topics for 2020 include:

  • Enrolling with government and commercial payers
  • Understanding the relationship between credentialing and enrollment
  • Utilizing the Medicare Provider Enrollment, Chain, and Ownership System (PECOS)
  • Filling out CMS forms for Medicare enrollment
  • Using CAQH solutions
  • Professional development and career advancement for enrollment professionals

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 timely reimbursement!

Who should attend?

  • Provider enrollment leads professionals
  • Credentialing specialists
  • Enrollment specialists
  • Payer credentialing Managers
  • Provider enrollment managers and supervisor
  • Practice administrators
  • Practice enrollment managers

Learning Objectives:

  • Successfully enroll your physicians with commercial and government payers 
  • Incorporate technology into traditional provider enrollment processes 
  • Discuss the similarities and differences between credentialing and provider enrollment

Tip: Enrollment professionals who are new to the field or veterans looking to brush up on the basics should be sure to register for our Provider Enrollment 101 preconference on April 19!

Full Agenda


12:00 p.m.–1:00 p.m.  


1:00 p.m.–2:10 p.m.    

Provider Enrollment 101

Terri Lynn Davis, BS

Industry veteran Terri Lynn Davis kicks off the preconference with an essential session on the foundations of provider enrollment. Learn important terminology, the steps in the enrollment process, and the difference between commercial and government payers.

2:10 p.m.–2:40 p.m.

Refreshment break

2:40 p.m.–3:50 p.m.    

Introduction to PECOS/I&A and Surrogacy


Experienced healthcare consultant David Zetter breaks down the Provider Enrollment, Chain, and Ownership System (PECOS), the Identity & Access Management System, and the National Plan & Provider Enumeration System (NPPES) into easy-to-understand pieces in this session. Zetter also introduces surrogacy and explains its importance.

4:00 p.m.–5:15 p.m.

What Is the Difference Between Credentialing and Payer Enrollment?

Terri Lynn Davis, BS

Join Terri Lynn Davis as she outlines the essential tasks involved in credentialing and payer enrollment. Learn the overlaps and differences between the two functions. In this session, Davis also explains the process of primary source verification and the processes for enrolling both new and existing practitioners and facilities.


Day 1 (Monday, April 20, 2020)


7:00 a.m.–8:00 a.m.

Registration and continental breakfast

8:00 a.m.–9:00 a.m.    

Navigating the Provider Enrollment Process

Sierra Farleman

Sierra Farleman from the Medicare Administrative Contractor (MAC) Novitas kicks off the conference with a session introducing the enrollment process and highlighting the roles of MACs. This session provides an overview of the various CMS forms you may need to enroll your practitioner or provider, touches on the application and revalidation processes, and details the top reasons why applications may require further development upon submission to a MAC.

9:10 a.m.–10:10 a.m.  

2020 Enrollment Regulations Updates

Abigail Kaericher

Get up to date on all new and upcoming regulatory changes, particularly regarding CMS and Medicare. Plus, get clarity on recent and upcoming changes to enrollment processes.

10:10 a.m.–10:40 a.m.

Networking break—Exhibit Hall

10:40 a.m.–11:40 a.m.

PECOS/I&A and NPPES Updates & Multifactor Authentication


Master the PECOS Identity & Access Management System to request surrogacy on behalf of providers. Plus, David Zetter clarifies how Delegated Officials and Authorized Officials take on different meanings when performing enrollment vs. acting as a surrogate.

11:40 a.m.–12:40 p.m.

Lunch provided—Exhibit Hall

12:40 p.m.–1:40 p.m.  

How to Complete the CMS-855I

Sierra Farleman

Sierra Farleman from the MAC Novitas explains in detail how to complete the CMS-855I form to enroll physician and nonphysician practitioners with Medicare. This session provides attendees with the unique opportunity to receive guidance directly from a MAC regarding how to complete a CMS-855 form.

1:50 p.m.–2:50 p.m.    

Maintaining Provider Enrollment and Performing Medicare Revalidations

Terri Lynn Davis, BS

Keeping your information updated and accurate with payers is crucial to a successful practice. This session provides tips for remaining organized, staying informed, and keeping payers up to date with your practitioners’ and group’s information. These best practices will help you ensure that no recredentialing or Medicare revalidations are ever missed.

2:50 p.m.–3:20 p.m.

Networking break—Exhibit Hall

3:20 p.m.–4:20 p.m.    

Contracting With Commercial Payers


Join David Zetter for an introduction to enrolling, contracting, and credentialing with commercial payers. Learn what to expect from the overall process, the vendors, and your staff when enrolling with commercial payers. Zetter also provides best practices for successful enrollment with these payers.

4:30 p.m.–5:30 p.m.

Introduction to CAQH Solutions

Jammal Dorsey, MBA, CSP, CSM, CSPO, and Christopher Swartz

Join industry experts Jammal Dorsey and Christopher Swartz as they discuss benefits healthcare organizations are achieving through the usage of CAQH services. Specifically, the representatives showcase real-world examples of how those solutions have improved provider data management and credentialing processes for health plans.  

5:30 p.m.–6:30 p.m.    

Networking reception—Exhibit Hall



Day 2 (Tuesday, April 21, 2020)


7:00 a.m.–8:00 a.m.    

Continental breakfast—Exhibit Hall

8:00 a.m.–9:00 a.m.

Credentialing Across the Continuum

Rachelle Silva, BBM, CPMSM, CPCS

This session provides a broad overview of the regulatory and accreditation standards required throughout the healthcare industry. Industry veteran Rachelle Silva discusses primary source verification requirements as well as how to develop clear and concise policies.

CHOW Down: Understanding How Changes of Ownership Can Impact a Healthcare Transaction

Brian Jent

In recent years, there has been a lot of consolidation and acquisition activity in the healthcare industry. Knowing what types of transactions trigger a change of ownership and what notices must be filed is critical to avoid a lapse in reimbursement or a closing of the transaction. This session provides guidance on specific change-of-ownership situations through real-life examples.

9:10 a.m.–10:10 a.m.  

Improve New Provider Onboarding to Increase Revenue


Would you like to guarantee payment for all services conducted by your practitioners from the day they start, without losing any money or productivity? In this session, David Zetter offers suggestions and actionable guidance to improve your new provider onboarding process so that practitioners can begin receiving reimbursement immediately upon starting.

10:10 a.m.–10:40 a.m.

Networking break with PECOS station—Exhibit Hall

10:40 a.m.–11:40 a.m.

Streamlining Data Exchange in Delegated Credentialing Relationships

Jammal Dorsey, MBA, CSP, CSM, CSPO, and Christopher Swartz

Health plans and provider groups across the country are beginning to adopt a data standard for exchanging delegated rosters to support reporting in delegated credentialing relationships. CAQH has built a portal called CAQH ProView for Groups that aligns with this standard and allows provider groups to submit rosters in a one-stop shop for multiple health plans. Learn how the standard is helping both provider groups and health plans streamline data exchange and other processes, and how this improves transparency between health plan and provider groups in provider enrollment and other use cases.

11:40 a.m.–12:40 p.m.

Lunch provided—Exhibit Hall

12:40 p.m.–1:40 p.m.  

How to Complete the CMS-855 Forms, Part 1

Lauren Hulls

Learn how to successfully complete the CMS-855A, CMS-855B, and CMS-855R to enroll or revalidate providers and suppliers with Medicare and to reassign a practitioner’s Medicare benefits. Attendees will also have the opportunity to ask questions regarding the forms.

1:50 p.m.–2:50 p.m.    

How to Complete the CMS-855 Forms, Part 2

Lauren Hulls

Learn how to successfully complete the CMS-855A, CMS-855B, and CMS-855R to enroll or revalidate providers and suppliers with Medicare and to reassign a practitioner’s Medicare benefits. Attendees will also have the opportunity to ask questions regarding the forms. Note: This session is a continuation of How to Complete the CMS-855 Forms, Part 1.

2:50 p.m.–3:20 p.m.    

Networking break with PECOS station—Exhibit Hall

3:20 p.m.–4:20 p.m.

Drowning in Duplication: Let’s Explore the Benefits of Delegation

Rachelle Silva, BBM, CPMSM, CPCS

This session evaluates the duplication in the credentialing process and explores the benefits of entering into delegated credentialing agreements to improve the timeliness of beginning the revenue cycle. Speaker Rachelle Silva also discusses professional development for provider enrollment specialists.

Payer Enrollment Challenges: Advanced Practice Professionals

Donna Goestenkors, CPMSM, and Yesenia Servin, CPMSM

Payer enrollment specialists are adept at juggling and tracking multiple providers. However, advanced practice professionals—such as nurse practitioners, physician assistants, and registered nurse anesthetists—can pose specific challenges to an industry once geared to physicians. Join Team Med Global’s Donna Goestenkors and Yesenia Servin as they discuss mechanisms to streamline payer enrollment for nonphysician practitioners and achieve optimal revenue recovery.


Day 3 (Wednesday, April 22, 2020)


7:00 a.m.–8:00 a.m.    

Continental breakfast

8:00 a.m.–9:10 a.m.

Beyond the Basics: Payer Enrollment Best Practices

Donna Goestenkors, CPMSM, and Nicole Keller, BS, MSHM, CPHQ, CPHIT, CSM

Payer enrollment is an ever-evolving field, one where an overlooked data point can cause reimbursement delays. Join Team Med Global’s Donna Goestenkors and Nicole Keller as they provide insights into the latest trends in payer enrollment and actionable information to increase the effectiveness of experienced payer enrollment specialists and team leaders.

9:20 a.m.–10:30 a.m.  

How to Cope With and Respond to Denials of CMS-855 Forms

Todd Selby, JD

Gain insight into why CMS-855 forms may be rejected and learn best practices for appealing rejections as well as avoiding them altogether. Healthcare consultant Todd Selby also provides case law examples of rejections to demonstrate how to apply this guidance to real-life scenarios.

10:30 a.m.–11:00 a.m.

Refreshment break

11:00 a.m.–12:00 p.m.

Jumpstarting Reimbursement: Mastering Medicaid Payer Enrollment

Donna Goestenkors, CPMSM, and Larry DeHoyos, CPCS, PESC

Payer enrollment accelerates an organization’s revenue cycle, but Medicaid turnaround times, retroactive physician enrollment, and out-of-state physician enrollment can put the brakes on timely reimbursements. To reverse delayed enrollment and streamline the payer process, join Team Med Global’s Donna Goestenkors and Larry DeHoyos as they discuss best practices for handling Medicaid enrollments to achieve your enrollment goals and circumvent stalled reimbursements.

Find the Agenda here.

**Agenda and Speakers Subject to Change**

Your Faculty

Terri Lynn Davis

Terri Lynn Davis, BS – Credentialing Director, 1st Assistant Credentialing Services

Terri Lynn Davis, BS, is a credentialing expert in payer enrollment and primary source verification services. Currently the credentialing director for 1st Assistant, she provides nationwide services for healthcare providers, suppliers, and facilities in numerous specialties. With over 15 years of experience in credentialing, she knows how to take the complex task of credentialing and make it a smooth and seamless process for 1st Assistant clients. She is never satisfied with the status quo but instead reaches for higher levels of excellence by simplifying processes, improving standards, and providing educational opportunities whenever possible. Customer service is her top priority, and her proactive expertise resonates with her clients. Davis also shares her knowledge and experience through a variety of webinars and conference presentations. Participants in her classes benefit from her practical credentialing tips that help drive improved payer enrollment outcomes. Davis holds a Bachelor of Science in healthcare administration with a minor in business management from Western Kentucky University.

Larry DeHoyos

Larry DeHoyos, CPCS, PESC Speakers' Team – Team Med Global Healthcare Consulting

Larry DeHoyos, CPCS, PESC, is a member of TMG’s Payer Enrollment Institute and Practice Management Alliance. As director of credentialing and payer enrollment with U.S. Dermatology Partners in Dallas, he oversees the organization’s health plan enrollment and provider credentialing functions for its 106 sites across the country. His focus includes centralizing systems and workflows and collaborating to help mitigate enrollment claim denials. DeHoyos has worked in provider credentialing and enrollment within managed care organizations, health systems, and single-specialty/multi-specialty medical groups supporting accrediting bodies such as The Joint Commission, NCQA, URAC, AAAHC, and CMS. He is a trained transformational healthcare champion whose expertise includes Lean workflow assessments for a paperless office environment, data governance, and provider directory management.

Jammal Dorsey

Jammal Dorsey, MBA, CSP, CSM, CSPO – Product Manager, CAQH

Jammal Dorsey, MBA, CSP, CSM, CSPO, is an energetic healthcare product manager and mentor with more than 15 years of experience in revenue cycle management and provider enrollment. He has spent his career working with federal, state, national, and regional healthcare organizations developing innovative solutions to reduce the complexity of healthcare data management. At CAQH, Dorsey collaborates with provider groups and health plans to streamline data exchange and other processes, aiming to improve the transparency and efficiency of provider enrollment and other use cases. An example of his efforts is ProView for Groups, which simplifies the process of maintaining and sharing delegated provider data used for provider enrollment, delegation oversight, and directory maintenance. Dorsey holds a Bachelor of Science in medical information technology from the University of West Florida and an MBA in business intelligence and analytics from H. Wayne Huizenga School of Business and Entrepreneurship at Nova Southeastern University.

Sierra Farleman

Sierra Farleman – Provider Outreach and Education Specialist, Novitas Solutions, Inc.

Sierra Farleman began working for Novitas Solutions as a customer service representative in the provider enrollment department. She then moved onto processing provider enrollment applications as a credentialing specialist. In that role, she started by processing paper applications and later moved on to processing PECOS applications. In 2018, she was hired within the provider outreach and education department as the provider enrollment liaison. In this current position, she spends the majority of her time providing education to the provider community to ease the transition into the Medicare program. Farleman holds a bachelor’s degree in education from Shippensburg University.

Donna Goestenkors

Donna Goestenkors, CPMSM Speakers' Team – Team Med Global Healthcare Consulting

Donna Goestenkors, CPMSM, is a consultant, speaker, author, educator, and mentor with more than 40 years of knowledge and experience in the medical staff services industry. She has expertise in virtually every type of healthcare organization, including hospital systems, medical staff services departments, CVOs, managed care organizations, group practices, and academic and critical access hospitals. Goestenkors is a past president of the National Association Medical Staff Services and serves as executive faculty for TMG University and the Executive MSP Program.

Lauren Hulls

Lauren Hulls – Attorney, Hall, Render, Killian, Heath & Lyman, P.C.

Lauren Hulls, JD, practices in the areas of regulatory compliance, reimbursement, billing, and payment practices. She provides counsel in developing strategies and policies for healthcare entities to ensure compliance with the Medicare and Medicaid programs, including provider-based issues, provider enrollment, evaluation of payment, disclosure, and compliance issues. Lauren advises a variety of healthcare clients including hospitals, health systems, home health agencies, hospice agencies, and physician practices. With the changes in Medicare reimbursement in recent years, Lauren has assisted clients with expanding service lines into freestanding payment models, with a focus on compliance with a number of different Medicare supplier types, including Independent Diagnostic Testing Facilities, Independent Laboratories, Durable Medical Equipment, Federally Qualified Health Centers, and Rural Health Centers. In her free time, Lauren enjoys spending time with her husband and three kids.

Brian Jent

Brian Jent – Shareholder, Hall, Render, Killian, Heath & Lyman, P.C.

Brian Jent works to solve licensing and regulatory issues with hospitals, ambulatory centers, and postacute providers, including nursing facilities, home health agencies, and hospices. He is often asked how providers can expand services under current restrictions and assists clients with compliance and reimbursement issues at the local, state, and federal levels. Jent is also a conduit to CMS, state agencies, and accreditation organizations for his clients. He regularly works with clients regarding provider enrollment and certification issues, specifically Medicare and Medicaid enrollment and participation requirements. A member of the American Health Lawyers Association, Indiana State Bar Association, and the Health Care Compliance Association, Jent maintains his licensure and status as a Registered Respiratory Therapist and Registered Pulmonary Function Technologist. Having worked in the hospital setting for more than 10 years prior to becoming an attorney, he understands the needs of healthcare providers and works with clients to provide practical and efficient solutions. In his free time, Jent enjoys spending time with his wife and three sons, playing golf, and reading.

Abigail Kaericher

Abigail Kaericher – Attorney, Hall, Render, Killian, Heath & Lyman, P.C.

Abby Kaericher, JD, practices in healthcare law with a focus on government relations and antitrust. She is active in the lobbying activities of Hall, Render, Killian, Heath & Lyman health law firm, representing the interests of healthcare clients. She developed an interest in antitrust after working with the Federal Trade Commission’s healthcare division. Kaericher earned her undergraduate degree in biology from Indiana University, her master's degree in Biology from Purdue University, and her JD with a Graduate Certificate in Health Law from Saint Louis University. While in law school, she served as an editor for the Saint Louis University Journal of Health Law & Policy. Additionally, she worked as a pediatric medical assistant.

Nicole Keller

Nicole Keller, BS, MSHM, CPHQ, CPHIT, CSM Speakers' Team – Team Med Global Healthcare Consulting

Nicole Keller, BS, MSHM, CPHQ, CPHIT, CSM, is a corporate quality assurance officer with Incyte Diagnostics, Inc. She provides leadership and oversight in the areas of technical and professional quality assurance and improvement; compliance; hospital credentialing and privileging; medical licenses and certification; and payer enrollment. Keller possesses the ability to clearly design and implement affordable, patient-centered systems and processes and form organizational collaborations to deliver cost-effective care. She is recognized by supervisors, peers, and staff for the ability to identify and analyze problems, interpret data, and recommend practical, acceptable solutions while developing strong teams and an organizational culture of continuous improvement and innovation. She is also adept at staying abreast of best practices in various healthcare settings needed to improve quality and drive change. Keller received her bachelor’s degree in community health from Western Washington University and her MHA from Champlain College. She is certified in Health Information Technology, Healthcare Quality Improvement, and Agile Project Management (Scrum Master). Family (fur babies included), physical fitness, nutrition, and mentoring/coaching high school and collegiate athletes are important aspects of Nicole’s personal life.

Todd Selby

Todd Selby, JD – Shareholder, Hall, Render, Killian, Heath & Lyman, P.C.

Todd Selby, JD, focuses on regulatory and compliance issues affecting all healthcare providers with an emphasis on long-term care, home health, and hospice providers. His practice is concentrated in the areas of licensure, certification, compliance, and reimbursement at the local, state, and federal levels. He also assists clients with Medicare and Medicaid enrollment and participation requirements and serves as a liaison between clients and regulatory agencies. Selby has extensive knowledge and experience in these areas and is recognized nationally by long-term care, home health, and hospice clients for his skills and proficiency. In addition to his representation of this unique client base, he frequently speaks before national and state healthcare providers and associations.

Yesenia Servin

Yesenia Servin, CPMSM Speakers' Team – Team Med Global Healthcare Consulting

Yesenia Servin, CPMSM, has more than 20 years of experience in payer enrollment and physician credentialing and is currently the payer enrollment lead at Loyola University Medical Center in Maywood, Illinois. There, she manages payer enrollment projects, briefs payer enrollment team members on industry trends, and is the liaison for the multitude of departments impacting payer enrollment processes. She also maintains her own consultancy, where she helps organizations develop and implement best practices guidelines and processes; analyzes a variety of commercial, private, and governmental claim filings; and manages credentialing processes for network participation agreements. Servin is a leading member of TMG’s Payer Enrollment Institute and serves as associate faculty on the Speakers’ Team.

Rachelle Silva

Rachelle Silva, BBM, CPMSM, CPCS – Credentialing Specialist, Multiplan, Inc.

Rachelle Silva, BBM, CPMSM, CPCS, is a dual-certified medical services professional with a bachelor’s degree in business management and 23 years of experience in the field. She has worked for MultiPlan, Inc., an NCQA-accredited national PPO network, for 14 years as an auditor in their delegated credentialing department and is a founding partner of Southern Belles and Beau, LLC Speaker’s Bureau. Her previous experience was as a medical staff coordinator/CME coordinator in a community hospital and manager of medical affairs/meeting management at a large academic facility. Silva has served in leadership positions at both the state and national level, including on the Education Committee and the Executive Board of the Louisiana Society of Medical Staff Services; the Certification Commission of the National Association Medical Staff Services (NAMSS) as a volunteer and elected test development chairperson and member of the Executive Board; and the NAMSS board as director at large. Silva is currently working for NAMSS as an instructor and for Team Med Global (TMG) as a product development team lead and faculty member for the TMG University Managed Care Pathway.

Christopher Swartz

Christopher Swartz – Product Manager, CAQH

Christopher Swartz worked extensively at CAQH to improve the quality of provider data made available to healthcare organizations. Prior to joining CAQH, he led consumer engagement efforts for a large electronic health record (EHR) vendor, focusing on outreach and practice portal solutions. He has participated in working groups focusing on leveraging blockchain technology to solve for a variety of use cases within healthcare, and he regularly monitors the adoption of HL7 FHIR within the industry. Having personal connections to those battling advanced cancer, Swartz prefers to work on projects where he can directly impact patients’ ability to access timely and accurate information that they can use to make informed healthcare decisions. When he’s not working, he spends time with his wife and two children in northern Virginia.

David Zetter

David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP – Senior Healthcare Consultant, Zetter Healthcare Management Consultants

David Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, is founder and president of Zetter HealthCare LLC. He and his firm have provided practice management consulting services to medical and dental practices, facilities, and organizations for more than 25 years. Zetter is a nationally recognized enrollment expert and speaker, and CMS regularly solicits his feedback in their PECOS and compliance user focus groups. He is the vice president of the National Society of Certified Healthcare Business Consultants and is a Certified Healthcare Business Consultant (CHBC). He is also a Certified Professional Coder (CPC) for physician practices, hospitals, and facilities, and a Certified Healthcare Compliance Consultant (CHCC). Zetter is a member of the American Health Lawyers Association, the Medical Group Management Association, and the Healthcare Financial Management Association. His firm supports client practices and facilities in all 50 states. You may find out more about Zetter and his firm at

Conference Location

New Orleans

Sheraton HotelWhere: Sheraton New Orleans Hotel
500 Canal Street
New Orleans, LA, 70130

Brimming with style but grounded in substance, Sheraton New Orleans Hotel is a premier downtown New Orleans destination just steps from the buzz of the French Quarter while offering seamless access to notable NOLA points of interest like the Ernest N. Morial Convention Center, Mercedes-Benz Superdome and Smoothie King Center. Relax in the refined guest rooms and suites, which boast plush bedding, spacious work areas, modern technology and floor-to-ceiling windows overlooking the French Quarter and the Mississippi River. For those craving authentic New Orleans cuisine, Roux Bistro fits the bill with creative Cajun cuisine, while Pelican Bar is ground-zero for colorful cocktails.


  • Fitness Center
  • Rooftop Pool
  • Complimentary computers & free Wi-Fi
  • Starbucks®
  • Roux Bistro
  • Pelican Bar

Room rate: $220/night
Hotel cut-off date: Monday, March 30, 2020
Toll-Free Reservation Center: (800) 325-3535 and reference DecisionHealth NPE Forum
Hotel Reservations:

Check-in and Check-out
Check-in: 4:00 PM
Check-out: 11:00 AM


Save up to $460 when you register by February 7, 2020!

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