2023 National Provider Enrollment Forum

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2023 National Provider Enrollment Forum

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2023 National Provider Enrollment Forum

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By registering for this event, you are agreeing to the terms outlined in our Event Registration Policies. Be sure to review them prior to registering so that you are aware of on-site expectations and our event cancellation policies.

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2023 National Provider Enrollment Forum

August 7–8, 2023 | Oak Brook, IL

DecisionHealth is happy to announce our 2023 National Provider Enrollment Forum will be held August 7–8, in Oak Brook (Chicago), Illinois!

The 2023 National Provider Enrollment Forum delivers two days of engaging education and training to provider enrollment professionals, enrollment managers, and credentialing specialists. Experienced veterans and top industry experts offer best practices and tips for developing and sustaining successful enrollment processes. Whether you’re 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!

Plus, all in-person attendees receive free access to additional online-only presentations to enjoy and expand this learning opportunity even further in November.

The 2023 National Provider Enrollment Forum is bursting with innovative speakers, fresh insights, and brand-new sessions!

As always, the National Provider Enrollment Forum provides continental breakfast, lunch, and snacks, and beverages during networking breaks, and a networking reception, all included with registration. Attendees will also have access to an event app that includes all session materials, a session planner, and unparalleled networking with peers.

We hope to see you in Illinois!

What’s new for 2023?

Hot topics for 2023 include:

  • NCQA and URAC standards
  • Billing locum tenens providers
  • Office of Inspector General exclusions
  • Enrolling with government and commercial payers
  • Merging credentialing and enrollment
  • Payer enrollment oversights
  • Complying with the No Surprises Act

Other features:

  • Speaker lineup with both new names and familiar faces
  • Dedicated Q&A opportunity at the end of every session

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!

Want to expand your learning even FURTHER? Check out these additional online educational opportunities!

Provider Enrollment Boot Camp
New to provider enrollment? Our on-demand eLearning course, Provider Enrollment Boot Camp, breaks down the key steps of enrolling practitioners—it’s a can’t-miss addition for those new to the field or looking to brush up on the fundamentals. Purchase it with a registration to the National Provider Enrollment Forum and save $100!

Fundamentals of Credentialing
New to medical staff services? Fundamentals of Credentialing is an on-demand eLearning course designed to help medical staff professionals understand what is meant by credentialing, privileging, and peer review, and how these three elements work in alignment to protect patients. Purchase it with a registration to the National Provider Enrollment Forum and save $100!

Purchase both training courses with your NPE 2023 registration and save $150!

2023 National Provider Enrollment Forum


Day 1 — Monday, August 7, 2023

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

8:00 a.m. – 9:00 a.m.
Mapping the Payer Enrollment Process
Donna Goestenkors, CPMSM, EMSP
Yesenia Servin, CPMSM, PESC
Whether you’re new to payer enrollment or a seasoned veteran, it’s important to map the enrollment process. Understand the big picture of payer enrollment and then drill down to actionable steps involved in pre-enrollment and post-enrollment success.

9:10 a.m. – 10:10 a.m.
Introduction PECOS, I&A, and NPPES
Join us to learn the key functions of the Provider Enrollment, Chain, and Ownership System (PECOS), Identity & Access Management System (I&A), and the National Plan & Provider Enumeration System (NPPES), as well as how they all work in tandem during the provider enrollment process.

10:10 a.m. – 10:40 a.m.
Networking & Refreshment Break

10:40 a.m. – 11:40 a.m.
Don't Let the No Surprises Act Catch You Off Guard
Cheryl Cisneros, RN, BSN, CPCS, CPMSM
If you contribute provider information to a health plan, or have an internal health plan, compliance tasks went into effect on January 1, 2022, as part of the No Surprises Act. This session will provide background and history, share current industry updates on the No Surprises Act, and touch on how to leverage your operations to stay compliant as well as bring the knowledge gained back to your organization.

11:40 a.m. – 12:40 p.m.
Networking Lunch-Provided

12:40 p.m. – 1:40 p.m.
Critical Skills to Elevate the Role of the Provider Enrollment Professional
Mathieu Gaulin, CPMSM, CPCS
Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP
This session will provide an overview of the critical skills needed to elevate the role of the provider enrollment professional (PEP) and tools to enhance your value, visibility, and effectiveness. This session will be part participant-centered learning, part didactic, and part question & answer.

1:50 p.m. – 2:50 p.m.
An Introduction to Enrolling With Private/Commercial Payers
If you’re new to enrolling, contracting, and credentialing providers with private/commercial payers or just need a refresher, join David Zetter as he shares best practices for completing these tasks. Learn how to do these processes efficiently, identify red flags that will require special attention, and practice ongoing maintenance.

2:50 p.m. – 3:20 p.m.
Networking & Refreshment Break

3:20 p.m. – 4:20 p.m.
Payer Enrollment Metrics
Larry DeHoyos, CPCS, PESC
Nicole Keller, MSHM, CPHQ, CPHIT, CSM
Because payer enrollment professionals are the gatekeepers of revenue, metrics are the key to judging success. Understand the reports needed to determine whether payers are adhering to their contracts and whether internal processes are producing the desired results.

4:30 p.m. – 5:30 p.m.
Ensure You Can Bill for Your Locum Tenens Providers: Setting Yourself Up for Success
Mathieu Gaulin, CPMSM, CPCS, Matthew Littlejohn
Do you struggle with the enrollment process when bringing a new locum tenens provider on board? It doesn’t have to be difficult. In this session, attendees will learn the correct way to enroll a locums provider in order to maintain their revenue stream while giving patients access to top-notch medical care. Attendees will learn how to roadmap their unique circumstances and understand why using locums providers is a vital staffing strategy. The audience will also learn how insurance payers view locums providers, so they can communicate with payers correctly, ensuring a quick and easy enrollment process.

5:30 p.m. – 6:30 p.m.
Networking Reception in the Exhibit Hall

Day 2 — Tuesday, August 8, 2023

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

8:00 a.m. – 9:00 a.m.
Leadership Lessons From the Cockpit
Mathieu Gaulin, CPMSM, CPCS, Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP
This session will explore leadership lessons learned from the trenches of medical staff services, provider enrollment, and medical staff governance. Join experienced MSP/PEP leaders who have lived through the good, the bad, the ugly, and the triumphs of being an MSP-PEP. Get real -life tips and advice on taking your leadership journey to the next level and look towards the future of the MSP’s role. You don’t want to miss all the hot topics, including hiring, motivating, recognizing, managing, and empowering staff across, the organization.

9:10 a.m. – 10:10 a.m.
What's New With NCQA and URAC Accreditation Standards?
Janet Wilson, BS, CPMSM, CPCS, FMSP
Compliance with national accreditation standards is critically important in our credentialing world. In this session, we will provide you with an overview of NCQA and URAC credentialing standards and identify the updates and compliance requirements that have been introduced in the past year.

10:10 a.m. – 10:40 a.m.
Networking & Refreshment Break

10:40 a.m. – 11:40 a.m.
Dealing With Denials of CMS- 855 Forms
Todd Selby, JD
Rejections of CMS-855 forms happen. Learn best practices for avoiding a rejection and what to do when appealing rejections in this session with healthcare attorney Todd Selby. He’ll use case law examples to explain why rejections happen and what lessons you can take away from them when responding to and appealing your own enrollment denials.

11:40 a.m. – 12:40 p.m.
Networking Lunch-Provided

12:40 p.m. – 1:40 p.m.
Payer Enrollment Oversights
Larry DeHoyos, CPCS, PESC
Yesenia Servin, CPMSM, PESC
When we focus on capturing waterfalls of revenue, the smaller streams can escape our attention. Uncover common oversights that leave money on the table. Learn everything from technical pointers to stakeholder strategies to tools and technologies.

1:50 p.m. – 2:50 p.m.
Understanding Exclusions
Sean J. Fahey, JD
Need help making sense of the Office of Inspector General’s (OIG) exclusion authority and processes? Join healthcare attorney Sean Fahey as he reviews the OIG’s guidance on screening for excluded individuals and entities, examines the effect of exclusion, and discusses the self-disclosure of the employment of excluded individuals.

2:50 p.m. – 3:05 p.m.
Networking & Refreshment Break

3:05 p.m. – 4:05 p.m.
Merging Credentialing and Payer Enrollment
Donna Goestenkors, CPMSM, EMSP
Rachelle Silva, BBM, CPMSM, CPCS
Increasingly, healthcare organizations are combining payer enrollment and credentialing. This integration is occurring in environments ranging from hospital systems to managed care, often as a result of organizational mergers and acquisitions or departmental consolidations. Understand the functions of this new frontier, which include credentialing, billing, and contracting.

Agenda subject to change

2023 National Provider Enrollment Forum


Cheryl Cisneros

Cheryl Cisneros, RN, BSN, CPMSM, CPCS
Independent Consultant

Cheryl Cisneros provides management consulting services that include health system credentialing, CVO, and enrollment process redesign and implementations. She has over 30 years of experience in credentialing, privileging, managed care, provider enrollment, utilization management, quality improvement and case management. She is recognized nationally as an enterprisewide process redesign expert with demonstrated ability to synthesize workflows into a collective and focused vision endorsed by key stakeholders. She has directed initiatives with outcome-based solutions, interpreting workflows and facilitating integration into software. Cisneros has worked as a leader within the National Association Medical Staff Services (NAMSS) and is a subject matter expert, knowledgeable in regulatory bodies.

Larry DeHoyos

Larry DeHoyos, CPCS, PESC
Team Member, Team Med Global Healthcare Consulting

Larry DeHoyos has been involved in the medical staff services, quality management, credentialing, provider enrollment and revenue cycle industries for over 22 years. His experience extends through medical groups, hospital systems, managed care plans and CVO environments. He is currently based in the Boston, Massachusetts area where he is the director of credentialing for a nurse staffing platform for post-acute care facilities. DeHoyos is a subject matter expert in provider enrollment, practice management, and acquisitions & integrations. He also serves as an associate faculty and member of the speaker team with Team Med Global (TMG) where he has developed and facilitated several webinars and educational workshops on lean workplace efficiencies, provider enrollment, provider credentialing, CVOs, accreditation preparedness, and practice management.

Sean J. Fahey

Sean J. Fahey, JD
Attorney, Hall, Render, Killian, Heath & Lyman, PC

Sean J. Fahey helps skilled nursing facilities, assisted living facilities, home health providers, and hospice providers navigate regulatory and compliance matters. He represents clients in all areas of healthcare compliance, governance, transactions, Medicare enrollment, administrative appeals, agreements, accounts receivable, and reimbursement recovery. Fahey counsels nonprofit clients on charitable operations and governance. He frequently speaks before national and state healthcare providers and associations on assisted living and skilled nursing facility issues.

Mathieu Gaulin

Mathieu Gaulin, CPMSM, CPCS
Senior Director of Professional Medical Staff Services, Boston Children’s Hospital

Mathieu Gaulin has been at Boston Children’s Hospital since 2006, starting as an agency temporary employee. He worked in provider enrollment for 10 years, during which time he created and managed the centralized provider enrollment team. Currently, he is the senior director of professional medical staff services with oversight of medical staff services and provider enrollment while working with the medical staff and its leaders on their self-governance and oversight of patient safety and quality obligations. He is currently a member of the Board of Advisors of the Institute of Contemporary Art/Boston, as well as an editorial board member of the Credentialing Resource Center. He is a recent alumnus of Harvard Business School and previously served on the National Association of Medical Staff Services (NAMSS) Membership Committee and as the secretary of the Massachusetts Association of Medical Staff Services (MAMSS). He is a national speaker and thought leader in multiple medical staff domains.

Donna Goestenkors

Donna Goestenkors, CPMSM, EMSP
President, Team Med Global Healthcare Consulting

Donna Goestenkors is a consultant, speaker, author, educator, and mentor with more than 47 years of knowledge and experience that she is privileged to share with colleagues, healthcare administrators, and medical staff leaders on issues pertinent to the medical staff services industry. Her expertise penetrates all healthcare locations and environments, including health systems; academic, community, and critical access hospitals; credentials verification organizations; payer enrollment; managed care organizations; and group and solo practice settings. Her talent in leading medical staff services professionals to their highest competence garners Goestenkors great respect among her industry colleagues.

Jenny Jackson

Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP
Senior Director, Provider Enrollment & Onboarding, Community Health Systems, Inc.

Jenny Jackson is a medical service professional with 22 years of experience in managed care and provider enrollment. She is the senior director of provider enrollment and onboarding for Community Health Systems in Nashville, Tennessee. Dr. Jackson is passionate about developing other leaders and specializes in building strong teams through communication, empathy, and trust. She believes that practicing servant leadership and putting people first is fundamental to the success of every organization. Dr. Jackson is a past president of the Kentucky Association of Medical Staff Services and is an instructor for NAMSS. She is a Certified Professional in Medical Services Management, a Certified Provider Credentialing Specialist, and a Fellow of NAMSS.

Nicole Keller

Nicole Keller, MSHM, CPHQ, CPHIT, CSM
Director of Medical Staff Services, Seattle Children's Hospital

Nicole Keller is a healthcare executive professional currently working as director of the medical staff services department with Seattle Children's Hospital. She provides leadership and oversight in the areas of technical and professional quality assurance, as well as improvement, compliance, hospital credentialing and privileging, medical licenses and certification, and payer enrollment. Keller's additional areas of expertise include human resources, payer and hospital contracting, population health, practice group management, project management, group leadership and facilitation, and building high-functioning teams.

Matthew Littlejohn

Matthew Littlejohn
Senior Provider Enrollment Specialist, LocumTenens.com

Matthew Littlejohn is a senior provider enrollment specialist with LocumTenens.com and thought leader, leveraging his extensive experience to empower healthcare clients to navigate the choppy waters of provider enrollment to prevent lost revenue. Starting his career seven years ago at ApolloMD, he subsequently joined LocumTenens.com, where he spent five years launching and growing the provider enrollment team to support a critical client need directly impacting healthcare organizations’ bottom lines. Currently, Littlejohn and the provider enrollment team advise clients of the process for enrolling locums clinicians and provide strategic consultation for clinician onboarding. Having discovered a passion for sharing his expertise and educating others, he has evolved into a pivotal industry voice on the subject of efficient and comprehensive provider enrollment.

Todd Selby

Todd Selby, JD
Shareholder, Hall, Render, Killian, Heath & Lyman, PC

Todd Selby 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, PESC
Payer Enrollment Lead, Team Med Global Healthcare Consulting

Yesenia Servin has more than 23 years of experience in payer enrollment and physician credentialing and is currently the payer enrollment lead at Team Med Global. 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 current member of the NAHRI Leadership Board. She is also 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 is a dual-certified medical services professional with a bachelor’s degree in business management and 25 years of experience in the field. She has worked for MultiPlan, Inc., an NCQA-accredited national PPO network, for 16 years as an auditor in their delegated credentialing department. Previously, she was a medical staff/CME coordinator in a community hospital and manager of medical affairs/meeting management at a large academic facility. She is also a founding partner of Southern Belles and Beau, LLC Speaker’s Bureau, which provides professional development and healthcare industry education across the continuum. 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 NAMSS certification commission as a volunteer and elected test development chairperson and member of the executive board; on the NAMSS board as director at large; and as a NAMSS instructor. Silva currently works with Team Med Global as faculty, speaker team member, and contributor to the TMG Accreditation Wizard.

Janet Wilson

Janet Wilson, BS, CPMSM, CPCS, FMSP
President, JLWilson Medstaff Consulting

Janet Wilson began her career in healthcare in 1986, and over the past 37 years she has managed and directed medical staff and credentialing services in independent and multihospital systems, ambulatory care centers, physician groups, health plans (delegated credentialing), and independent and system credentials verification organizations. She served for three years on the board of directors of NAMSS. She also served on the board of directors of the Texas Society for Medical Services Specialists and served as its president during her six-year tenure. She has served as an independent educator and consultant in the healthcare industry for 15 years and has spoken at numerous state and national conferences. In addition, she has served as faculty for Edge-U-Cate, LLC, and taught certification-focused study programs and other industry-related programs. Wilson also served as a NAMSS instructor for 10 years and has participated in the development of education programs related to credentialing and privileging, managed care, leadership, and professional development.

David J. Zetter

Founder & President, Zetter Healthcare Management Consultants

David J. Zetter 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 current president of the National Society of Certified Healthcare Business Consultants and a Certified Professional Coder (CPC) for physician practices, hospitals, and facilities. 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.

2023 National Provider Enrollment Forum


Hilton Chicago/Oak Brook Hills Resort & Conference Center
3500 Midwest Road
Oak Brook, IL 60523

Self-parking is complimentary for conference attendees.

Room rate: $169/night plus taxes and fees
Hotel cut-off date: Friday, July 14, 2023. Hotel rooms may sell out earlier than the cut-off date, so book early!
Reservation Center: 630-850-5555 and referencing the National Provider Enrollment Forum room block
Reservations URL: https://www.hilton.com/en/attend-my-event/chibhhh-npefor-cb7996a5-7782-4b85-8626-4c585c4c6110/
Hotel website: https://www.hilton.com/en/hotels/chibhhh-hilton-chicago-oak-brook-hills-resort-and-conference-center/

Simplify Compliance/DecisionHealth has no affiliation with any third-party companies or travel assistance providers. Rooms should be booked directly with the event hotel using the official information provided on the website and in the brochure.

2023 National Provider Enrollment Forum




RL Datix

Team Med Global Consulting, LLC

2023 National Provider Enrollment Forum

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