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Description
- Discuss credentialing & enrollment processes that impact your revenue cycle
- Recognize billing processes including service entry, claim submission, and revenue cycle management
- Explore Medicare enrollment and the benefits of participating.
Learning Objectives
- How do I know that a CMS 855I application is needed if I use PECOS for Medicare?
- When is an 855R application required?
- What is the correspondence/mailing address that should be listed on the 855I application?
- Understanding CMS Medicare’s use of the term "provider(s)."
- How to obtain compliant access to your provider’s Medicare applications.
- The designated contact person on every Medicare application should only be.
- Adverse actions must be reported on an 855I application.
- Medicare allows corrections to be responded to within a specified timeframe.
- The process for completing and mailing out Medicare paper applications.
- The CMS-compliant process to connect with healthcare providers, whether individuals or organizations.
- Medicare revalidations are urgent, and the timeline is.
- When you receive a request to correct the address(es) on your application, which section(s) should you check?
- Key requirements for completing the 855R application.
- Consistency in language from MAC representatives when requesting corrections or providing rejection letters.
- When completing the banking information section, the address listed must match the address on the Medicare application.
Speaker
Yesenia Servin is a nationally certified credentialing manager and provider enrollment specialist with over 27 years of experience in the healthcare industry. As an expert in credentialing and provider/payer enrollment, she has a deep understanding of Medicare & Medicaid enrollment.
Currently, Yesenia is the Director of Contracting, Credentialing & Provider Enrollment at United Vein & Vascular Centers. Through YS Credentialing PLLC, she assists organizations in developing and implementing best practices, guidelines, and processes, and guides the credentialing and payer enrollment structure.
Yesenia excels at training and mentoring administrative, credentialing, and enrollment healthcare professionals.
Her responsibilities include managing payer enrollment, keeping colleagues informed on industry trends, and serving as a liaison to all departments affecting payer-enrollment processes. She provides revenue cycle consulting services to various healthcare providers and organizations, including those focused on durable medical equipment, hospital and health systems, community mental health organizations, and global managed care organizations.
Yesenia is actively involved in professional and academic roles:
- Current Charter Oak University Faculty
- NAMSS member (and past NAMSS Educational Conference Guest Speaker)
- Current member of the NAHRI Leadership Council
- Current trainer for The Chicago School of Professional Psychology
- TMG Collaborator
She holds academic training in microeconomics and communications from NEIU and healthcare administration from Concordia University Chicago. In her personal time, Yesenia enjoys spending time with her family and pugs, and finds joy in trekking across the US states and regions.