Mastering Credentialing and Enrollment 2025 – 3-Part Series

Description

Credentialing and payer enrollment are critical drivers of your organization’s revenue cycle, and getting them wrong can mean costly delays, denials, and lost revenue. This comprehensive three-part webinar series, led by credentialing expert Yesenia Servin, CPMSM, PESC, provides an in-depth roadmap to mastering every stage of the provider enrollment and credentialing process.

From the foundational elements of payer enrollment to the intricate details of CMS-855 forms, revalidation, PECOS submissions, and NPPES account management, this series equips healthcare organizations with the tools and strategies to ensure smooth, compliant, and successful enrollment across all levels.

 

Part 1 -  Medicare Provider Enrollment 101: Complete Enrollment and Credentialing Process for Providers

 

Timing -  1:00 PM EST

 

Enrolling with the Medicare program involves the various CMS-855 forms. There are now different forms that must be used by different providers of healthcare services or products. These forms are long, detailed, and sometimes confusing. Not only must they be filed initially for a given provider, but they must also be maintained and updated as appropriate. Due to the increasing complexity of healthcare delivery systems, providers, such as integrated delivery systems or large multi-specialty clinics, may have to maintain hundreds of these forms. Join expert Yesenia Servin, CPMSM, PESC, for this detailed review of the CMS 855 forms for Medicare participation. We will review both the paper applications and PECOS applications, Facility apps, Organization apps, and Individual apps. Failure to use the updated forms can cause outright rejection of the application and lead to significant delays in getting your providers enrolled.

 

Learning Objectives:-

 

• Overview of CMS connection in order to remain compliant and to successfully complete Medicare provider applications
• Understand Part A Facility applications
• Understand the part B organization app and individual apps
• Understand reassignment apps
• To review the Medicare enrollment process through the use of the various CMS-855 forms
• To address changes to the CMS-855 forms and/or changes in interpretations of the forms
• To discuss the revalidation process for the various CMS-855 forms
• Review each section of the application within PECOS
• Know the payer-specific rules and requirements of both government and commercial payers.

 

Part 2 - Credentialing 102 - A Detailed Guide to Provider Enrollment 2025

 

Timing -  2:20 PM EST

 

This is the second session of our Credentialing and Enrollment series. Yesenia presents this detailed, comprehensive webinar, teaching you to successfully credential your providers and mid-level providers. This webinar features a complete step-by-step guide to provider credentialing, including customizable forms for payer/application cover letters, provider documentation requirements, Verification of Documentation, CV requirements, application submission, payer linkage, provider revalidation, employment history, and much more! You will be provided tracking tools to aid in the tracking/verification of provider documents and payer application tracking.

 

Learning Objectives:-

 

• Setup/Maintenance/Attestation of CAQH, PECOS, NPPES, I&A
• How to complete the payer enrollment applications
• Follow-up process for provider enrollment applications
• Payer-specific requirements for applications and submission
• Payer-specific contact and submission information
• Tracking of payer enrollment application packages.

 

Part 3 - Credentialing 103 - A Detailed Guide to Provider Enrollment 2025

 

Timing -  3:30 PM EST

 

The NPPES interface is complex and confusing. Your organization and providers' CMS National Plan and Provider Enumeration System (NPPES) account is about so much more than just acquiring a National Provider Identifier (NPI), but maintaining it accurately and compliantly can be confusing and frustrating. Whether you have just one or 50 accounts to manage, you can improve your results with expert guidance from nationally certified credentialing specialist, Yesenia Servin, CPMSM, PESC.

 

Learning Objectives:-

 

• Setup/Maintenance/Attestation of NPPES, I&A
• How to complete the payer enrollment applications
• Follow-up process for provider enrollment applications
• Payer-specific requirements for applications and submission
• Payer-specific contact and submission information
• Tracking of payer enrollment application packages
  • Create a strong I & A to securely access CMS systems such as NPPES & PECOS
  • Utilize the surrogacy program to easily manage multiple NPPES accounts within your own account
  • Accurately and efficiently complete an NPPES registration on the first try
  • Manage multiple NPI profiles within your own account
  • Understand specialties and taxonomies

 

Who Will Benefit? 

 

• Practice Manager / Practice Management
• Credentialing Specialist / Credentialing Staff
• Provider Enrollment Specialist
• Revenue Cycle Manager / Revenue Cycle Management Staff
• Medical Office Manager
• Operations Manager / Operations Staff
• EFT Enrollment Specialist
• Healthcare Administrator / Healthcare Administration
• Billing Specialist
• Compliance Officer
• Medical Staff Services Professional
• Network Management Staff
• Enrollment Coordinator
• Credentialing Coordinator
• Provider Relations Specialist
• Healthcare Consultant
• Health Plan Enrollment Analyst.