2022 National Provider Enrollment Forum

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2022 National Provider Enrollment Forum

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2022 National Provider Enrollment Forum

September 19–20, 2022 | Phoenix, Arizona

DecisionHealth is happy to announce our 2022 National Provider Enrollment Forum, will be held September 19–20, in lovely Phoenix, Arizona.

The 2022 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!

After attending this conference, learners will be able to:

  • Understand how to enroll practitioners and facilities with both government and private payers
  • Explain the importance of a thorough credentialing process
  • Describe key considerations for peer review
  • List opportunities for professional development and career growth


Plus, don't miss:

  • Expanded speaker lineup featuring both new names and familiar faces
  • Dedicated Q&A opportunity at the end of every session
  • Measures to keep you safe—this year’s Forum is a limited-touch event with no printed materials
  • 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!

Event Cancellation & Related Policies
By registering for this event, you are agreeing to the terms outlined in our Event Registration Policy. Please review the complete document here for details around cancellations, refunds, and your on-site experience.

2022 National Provider Enrollment Forum

Agenda

Day 1 — Monday, September 19, 2022

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

8:00 a.m. – 9:00 a.m.
Provider Enrollment Basics: What to Do on Day 1, Week 1, Month 1, Year 1
Mathieu Gaulin, CPMSM, CPCS, and Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP
Congratulations, you’re a Provider Enrollment Professional! Now what? This presentation will walk you through some tips for getting you through Day 1, Week 1, Month 1 and Year 1. Leave better prepared to tackle the most common Enrollment challenges and questions.

9:10 a.m. – 10:10 a.m.
Understanding PECOS, I&A, and NPPES
David J. Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP
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). 

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

10:40 a.m. – 11:40 a.m.
Gold Star Credentialing: Best Practices for Achieving Compliance
Donna Goestenkors, CPMSM, and Stephanie Russell, BS, CPMSM, CPCS
Verifying and evaluating practitioner credentials is critical, but so is managing decision makers' expectations and circumventing misunderstandings. Join Team Med Global to learn how to lay the groundwork for informed discussions about competency measurements among medical staff leaders, administrative leaders, and MSPs.

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

12:40 p.m. – 1:40 p.m.
Improving New Provider Onboarding to Boost Revenue
David J. Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP
Having an effective new provider onboarding process protects against losing money and productivity. Ensure your practitioners can begin receiving reimbursement immediately upon starting by attending this session with David Zetter. Walk away with actionable guidance to improve your onboarding process to ensure there are no gaps in reimbursement when a new provider starts.

1:50 p.m. – 2:50 p.m.
Eliminating Enrollment Delays Through Delegated Credentialing
Amy M. Niehaus, MBA, CPMSM, CPCS
An efficient enrollment process is critical for any healthcare organization's revenue cycle but waiting for payers to complete their credentialing process takes time, and usually at a significant cost to the organization in terms of lost or delayed revenue. Attaining delegated status with commercial payers provides the opportunity for organizations to enroll new providers faster and eliminate enrollment delays. This session will provide attendees with the steps to achieve delegation status, including determining eligibility and approaches to establishing a compliant credentialing program.

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

3:20 p.m. – 4:20 p.m.
Enrolling With Private/Commercial Payers
David J. Zetter, PHR, SHRM-CP, CHC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP
Join David Zetter as he provides an overview of the process of enrolling, contracting, and credentialing your providers with private/commercial payers. He'll share best practices for completing these tasks efficiently and on time, identifying the red flags that will require special attention, and practicing ongoing maintenance.

4:30 p.m. – 5:30 p.m.
Laying the Groundwork: Defining Payer Enrollment Competency
Larry DeHoyos, CPCS, PESC, and Yesenia Servin, CPMSM, PESC
Many of us consider ourselves to be payer enrollment specialists, but what does payer enrollment competency really mean? Join Team Med Global as they provide an overview of the Executive Payer Enrollment Competency Model and outline Team Med Global’s Executive Payer Enrollment Professional education program.

5:30 p.m. – 6:30 p.m.
Networking Reception


 

Day 2 — Tuesday, September 20, 2022

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

8:00 a.m. – 9:00 a.m.
Payer Enrollment, Credentialing, and the No Surprises Act
Stacy Brklacich, JD, and LaShawna Brown, CPMSM, CPCS
Payer enrollment specialists and credentialing specialists alike know that what we do has an effect on the qualityofcare patients receive. In this session we will learn how we can further help patients through understanding the No Surprises Act, what information we have that organizations need for compliance, and how we can continue to work together for the good of the patient.

9:10 a.m. – 10:10 a.m.
Is Anybody Out There? Working and Managing in a Virtual Environment During COVID-19 and Beyond
Amy M. Niehaus, MBA, CPMSM, CPCS
The virtual work environment has become center stage during COVID-19. Employees and managers are working from home whether they were prepared to do so or not. Traditional methods of working with or managing a team may not be as effective when everyone is in a different location. This webinar will address common challenges to working effectively within a virtual setting, including the use of technology, communication techniques, managing performance and keeping staff engaged.

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

10:40 a.m. – 11:40 a.m.
Assembling Your Provider Enrollment Toolbox
Mathieu Gaulin, CPMSM, CPCS, and Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP
To be truly effective as a provider enrollment professional, you need all the tools at your disposal but sometimes you only have a hammer. This session will help you identify and implement all the real-world tools to address day-to-day functions and advanced provider enrollment challenges. As a bonus, the slides for this session can be used as checklists to help with your daily work.

11:40 a.m. – 12:50 p.m.
Networking Lunch – Provided

12:50 p.m. – 1:50 p.m.
Making Connections: Telemedicine & Credentialing by Proxy
Donna Goestenkors, CPMSM, and Rachelle Silva, BBM, CPMSM, CPCS
Telemedicine providers may never set foot in a facility, yet they’re held to the same standards as onsite physicians. Join Team Med Global to up your knowledge of Medicare CoPs and other telemedicine accreditation standards, and how to onramp telemedicine credentialing and privileging into existing processes.

2:00 p.m. – 3:00 p.m.
What to Do With a Denial of a CMS 855 Form
Todd Selby, JD
Healthcare attorney Todd Selby shares best practices for avoiding having a CMS-855 form rejected and what do when appealing rejections. Using case law examples, he'll explain why rejections occurred and what lessons you can take away from them to apply when responding to and appealing your own enrollment denials.

3:00 p.m. – 3:15 p.m.
Networking & Refreshment Break

3:15 p.m. – 4:15 p.m.
True Grit: Developing Your Resilience
Donna Goestenkors, CPMSM, Nicole Keller, MSHM, CPHQ, CPHIT, CSM, and Stephanie Russell, BS, CPMSM, CPCS
Setbacks are difficult, but you can bounce back – sometimes in unexpected ways. Join Team Med Global in exploring how to develop resilience, the skill that prevents you from getting stuck and propels you to the next opportunity. Then, learn how to create your personal plan for thriving in the face of workplace stressors.


Agenda subject to change

2022 National Provider Enrollment Forum

Speakers

Stacy Brklacich, JD
Legal Counsel, Integris Health System

Stacy Brklacich, JD, earned her law degree from the University of Tulsa and has devoted her legal practice to the representation of hospitals, physicians, nurses, payers, and other healthcare providers in the areas of healthcare contracting, risk management, litigation management, licensing, moral and medical ethics, peer review, and credentialing. Brklacich provides legal representation to physicians, nurses, and physician assistants as well as practice groups in the areas of risk management, bylaws, policies, documentation, and compliance. She has also worked for a payer and focused on medical policy, clinical payment and coding policies, member disputes, and insurance legislation.  Brklacich is a member of the Oklahoma Bar Association, Tulsa County Bar Association, and American Health Lawyers Association. In addition, she is a frequent lecturer to hospitals, physician groups, and healthcare entities in the areas of risk management, hospital operations, peer review, and credentialing.


LaShawna Brown, CPMSM, CPCS
Credentialing Manager, CommunityCare Managed Healthcare Plans of Oklahoma
Founder, On A Mission Credentialing

LaShawna Brown, CPMSM, CPCS, is the credentialing manager for CommunityCare Managed Healthcare Plans of Oklahoma and founder of On A Mission Credentialing. Brown started her career in 2001 as a medical staff office receptionist. In 2013, she became the director of medical staff services and centralized credentialing for a six-hospital health system and served in that that role for nearly seven years. In 2019, she joined an Oklahoma health insurance company quickly began learning the managed care side of credentialing. Realizing the significant misnomers regarding the managed care process, she launched her blog, On A Mission Credentialing, in 2021, to provide knowledge gleaned from 20 years of experience in the credentialing realm.


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 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.


Mathieu Gaulin, CPMSM, CPCS
Director of Health Affairs, Boston Children's Hospital

Mathieu Gaulin, CPMSM, CPCS, has been at Boston Children’s Hospital since 2006, starting as an agency temporary employee. Gaulin worked in Provider Enrollment for 11 years, during which time he created and managed the centralized Provider Enrollment Team. Currently, he is the Director of Health Affairs with oversight of Medical Staff Services and Provider Enrollment while working with the Medical Staff and its Leaders on their self-governance. To that end, he serves as the Secretary of the Medical Staff Executive Committee and the administrator for the Medical Peer Review Committee, Credentials Committee, Bylaws Review Committee amongst others. He served as the Secretary of the Massachusetts Association of Medical Staff Services (MAMSS) for close to 5 years. He is currently the Chair of the Membership Committee of the National Association for Medical Staff Services (NAMSS) and collaborates with them on other initiatives as a volunteer leader.


Donna Goestenkors, CPMSM
President, Team Med Global Healthcare Consulting

Donna Goestenkors, CPMSM, is a consultant, speaker, author, educator, and mentor with more than 46 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, EdD, MBA, CPMSM, CPCS, FMSP
Senior Director, Provider Enrollment & Onboarding, Community Health Systems, Inc.

Jenny Jackson, EdD, MBA, CPMSM, CPCS, FMSP, is a medical service professional (MSP) with 22 years of experience in managed care and provider enrollment. She is the Senior Director of Provider Enrollment and Credentialing Verification Services for Community Health Systems in Nashville, Tennessee. 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. Jackson is a past president of the Kentucky Association of Medical Staff Services, a Certified Professional in Medical Services Management, a Certified Provider Credentialing Specialist, and a Fellow of NAMSS.  She holds a Master of Business Administration and an Educational Doctorate in Organizational Leadership from Western Kentucky University.


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

Nicole Keller, MSHM, CPHQ, CPHIT, CSM, 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.


Amy M. Niehaus, MBA, CPMSM, CPCS
President, AMN Consulting, LLC

Amy M. Niehaus, MBA, CPMSM, CPCS, is an independent healthcare consultant with more than 30 years of experience in the medical services and credentialing profession advising clients in the areas of accreditation, regulatory compliance, credentialing, privileging, operational efficiency, technology, credentialing policies and procedures, enrollment, and delegation. Niehaus has worked in multiple environments throughout her career, including acute care hospitals, CVOs, health plans, and consulting firms. She is dual certified by the National Association Medical Staff Services (NAMSS) and has served in multiple roles including NAMSS instructor, subject matter expert, and chair of the association’s education committee.  She is a former president of the Missouri Association Medical Staff Services and the Greater St. Louis Area chapter. Niehaus has been a frequent speaker and educator has authored and contributed to a variety of industry-related publications. She is the author of Managed Care Credentialing: Compliance Strategies for Health Plans, CVOs, and Delegated Entities (HCPro, 2019).


Stephanie Russell, BS, CPMSM, CPCS
Regional Director, UCHealth in Colorado Springs

Stephanie Russell, BS, CPMSM, CPCS, is the southern region director of medical staff services and credentialing at UCHealth in Colorado Springs, Colorado. She has been an executive medical staff services professional for over 30 years overseeing medical staff affairs, including medical education, graduate medical education, bylaws, regulatory compliance and accreditation, health system credentialing for both hospital and health plans, credentialing service contracts for outside entities, as well as delegation agreements and audits. She currently oversees four facilities, with three medical staffs, including a critical access hospital. She was an instructor for the National Association of Medical Staff Services (NAMSS) for over 10 years and has made many presentations at state and national education conferences throughout the country on topics related to credentialing, privileging, professional development, and regulatory compliance for both NCQA and The Joint Commission. She is also a past NAMSS Board member, IAMSS State president and has been a collaborator and coach with Team Med Global since its inception expanding her teachings to include practice management, managed care and quality for medical staffs and hospitals. She is the co-author of Verify and Comply: Credentialing, Medical Staff, and Ambulatory Care Standards.


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

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, CPMSM, PESC
Payer Enrollment Lead, Team Med Global Healthcare Consulting

Yesenia Servin, CPMSM, PESC, has more than 23 years of experience in payer enrollment and physician credentialing and is currently the payer enrollment lead at Team Med Global (TMG). 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, 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 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 the education committee and executive board of the Louisiana Society of Medical Staff Services; the NAMSS Certification Commission; Director at Large on the NAMSS board; and former NAMSS instructor. Silva currently works with Team Med Global (TMG) as faculty, speaker team member, and contributor to the TMG Accreditation Wizard.


David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP
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 the current 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.

2022 National Provider Enrollment Forum

Pricing

2022 National Provider Enrollment Forum
Retail Price: $1499
Early Bird Price: $1399 — Expires July 13, 2022!

Bundle and Save!
Interested in additional learning opportunities?
Add the Provider Enrollment Boot Camp or Fundamentals of Credentialing Boot Camp to your cart and save up to $200 before the early bird deadline on July13th!

National Provider Enrollment Forum + Provider Enrollment Boot Camp = $1,698 (after early bird July 14: $1,798)
National Provider Enrollment Forum + Fundamentals of Credentialing Boot camp $1,698 (after early bird July 14: $1,798)
National Provider Enrollment Forum + Provider Enrollment Boot Camp + Fundamentals of Credentialing Boot Camp = $2,097 (after early bird July 14: $2,197)

Group pricing is as follows:

  • 4-10 attendees = each attendee receives 10% discount off retail price
  • 11-15 attendees = each attendee receives 15% discount off retail price
  • 16-20 attendees = each attendee receives 20% discount off retail price
  • 21 or more attendees = each attendees receive 25% discount off retail price

Contact John Prentice or Megan Ireland at 1-855-225-5341 x4005 or email us at HCEvents@hcpro.com.

2022 National Provider Enrollment Forum

Location

Hilton Phoenix Resort at the Peak
7677 N 16th Street
Phoenix, AZ 85020

Room rate: $179.00 single/double occupancy (inclusive of the Daily Resort Charge). These rates are subject to applicable taxes. Daily Resort Charge includes guest high speed internet access; River Ranch, miniature golf and health club access for 4; tennis court access and daily fitness classes for 2; local and toll-free calls
Booking Link: https://group.hilton.com/msw7dc
Hotel cut-off date: Sunday, August 28, 2022
Toll-Free Reservation Center: 1-800-445-8667 & referencing the DecisionHealth National Provider Enrollment Forum room block
Hotel website: https://www.hilton.com/en/hotels/phxsppr-hilton-phoenix-resort-at-the-peak/

Reservations
Simplify Compliance/DecisionHealth has no affiliation with any third-party companies or travel assistance providers.

2022 National Provider Enrollment Forum

Sponsors/Exhibitors

Diamond Sponsor:

VerityStream

Exhibitors:

American board of Physician Specialties (ABPS)
MD-Staff
RL Datix
Team Med Global Consulting, LLC
Trizetto Provider Solutions

For information on exhibit and sponsorship opportunities, please contact Regina Dexter at rdexter@decisionhealth.com.

2022 National Provider Enrollment Forum

Health & Safety

Simplify Compliance and Decision Health place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:

  • Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
  • Food service will follow the safety guidelines implemented by the hotel.

To view all the safety measures that the Hilton Phoenix Resort at the Peak has implemented, please see the information listed on their website: https://www.hilton.com/en/corporate/cleanstay/.

Simplify Compliance and Decision Health will continue to monitor the COVID-19 environment and the recommended guidelines, and will communicate adjustments to the onsite policies and procedures as we approach the live event date.