Title 1 - Credentialing 102 - A Detailed Guide to Provider Enrollment 2025

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.

• Provider Documentation Requirements
• Verification/Validation of Provider Documents
• Provider Document Tracking
• Setup/Maintenance of Provider File
• Setup/Maintenance of CAQH, PECOS, NPPES, I/A
• Provider Portals & Profiles
• Payer application requirements
• Payer application prep/submission
• Payer-specific enrollment information
• Payer application tracking
• Medicare/Medicaid Enrollment
• Provider Linkage to Payer
• Efficient and Timely Communication
• Steps to complete once the provider is approved by the payer
• Multiple Printable/Customizable Forms, Letters, Tracking Tools

The NPPES interface is complex and confusing. Your organisation 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.

• Review that the taxonomy details are accurate.
• What if your application gets denied or rejected?
• What if your claims are being labelled as out of Network, but you have an in-network approval?

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
  • Utilise 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 account
  • Understand specialities and taxonomies.

Who Should Attend

• Practice Managers
• PESC
• CPMSM
• Revenue Cycle
• Directors
• CFO
• Credentialing
• Provider Enrollment
• EFT Enrollment
• Operations.