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National Provider Enrollment Forum (BLR)
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National Provider Enrollment Forum 2020
Join top Medicare enrollment experts for four intensive days of hands-on enrollment training that solves real world enrollment problems.
Take the frustration out of enrolling and credentialing! Get step-by-step training and answers to your most pressing questions. 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 uninterrupted billing!
DecisionHealth, HCPro and HealthLeaders Media are now the H3.Group. This gives you expanded opportunity to connect with more healthcare leaders within the industry than ever before. You will have the chance to learn from the nation’s leading enrollment experts. This year we are expanding the private payer presence and including credentialing information.
With four intensive days of hands-on training with our nationally-recognized experts, you’ll:
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Get the first word on PECOS and NPPES updates and next generation applications that have been implemented due to input from participants at this event
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Recognize the warning signs that may cause deactivation, revocation or denial to your organization’s enrollment
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Receive a plain-English walk through of the CAQH ProView application
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Get a side-by-side, field-by-field demonstration of how to fill out each 855 paper form and its online PECOS equivalent
This is your only chance to network with the nations top enrollment experts. They will provide you with real-life answers to your organization’s unique enrollment problems. You will have the opportunity to network with peers from other states and provider settings to discover tips and best practice strategies for efficiently managing enrollment and credentialing workloads!
PLUS Preconference day tailored to beginners - get up-to-speed on the basics to prepare for the main conference!
3+ hours of dedicated Q&A
directly with experts
Step-by-step
beginning to end enrollment process
Online PECOS vs. print
enrollment demonstration side-by-side
Preconference Agenda
Sunday, September 16
12:00 p.m. – 1:00 p.m.
Registration
1:00 p.m. – 2:30 p.m.
Provider Enrollment 101
Gretchin Heckenlively
Jumpstart your mastery of Medicare enrollment as we untangle the web of CMS-855 forms and Medicare enrollment jargon. In this session you will learn:
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Timelines, key definitions, available resources and organizational structures: Don’t know the difference between delegated official vs. authorized official? We’ll clarify more than 20 enrollment terms that are easily misunderstood. Plus, we’ll take you through ownership scenarios from sole proprietorships to corporations to illustrate the differences between eight business structures and all 40 certified provider and certified supplier types from FQHCs to HHAs that will impact what information is required on the CMS-855 forms.
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Medicare enrollment in plain English — acronyms, applying for NPIs, PAR status: Learn how to stay afloat in the alphabet soup of acronyms as enrollment terms are translated into what they all mean and how and when they are important to you. Do you know what CORFs, EFTs, OPOs, NPIs, NPPES, and PTANs refer to? After this session, you’ll be singing the ABCs of enrollment and fully understand all the terminology like a pro.
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Introduction to the CMS-855 forms: We’ll walk through all seven CMS-855 forms, give you insights on key differences and help you select the appropriate form to use.
2:30 p.m. – 2:45 p.m.
Refreshment Break
2:45 p.m. – 4:15 p.m.
Provider Enrollment 101 (continued)
Gretchin Heckenlively
4:15 p.m. – 4:30 p.m.
Break
4:30 p.m. – 5:30 p.m.
PECOS Organizational Access for Beginners
Gretchin Heckenlively
Get a step-by-step walkthrough of the online PECOS enrollment process — from navigating NPPES to obtaining an NPI. Watch as our expert sets up physicians within PECOS using the very same steps you would.
5:30 p.m.
Preconference Adjourns
**Agenda and Speakers Subject to Change**
More than 3 hours
of dedicated Q&A
Look for the QA icon for opportunities to get your challenges solved with direct access to the top enrollment and credentialing consultants in the country!
3+ hours of dedicated Q&A
directly with experts
Step-by-step
beginning to end
Online PECOS vs. print
enrollment demonstration side-by-side
Agenda Day 1
Monday, September 17
7:00 a.m. – 8:00 a.m.
Registration/Continental Breakfast
8:00 a.m. – 8:10 a.m.
Welcome and Announcements
8:10 a.m. – 10:30 a.m.
Enrollment Risks and Consequences — Steps in the Enrollment Process, Filing and Effective Date Considerations, Deactivation & More
Dennis Grindle and Gretchin Heckenlively
The Medicare enrollment process is more than completing some boxes on a form or in electronic data fields in the national PECOS database. This session highlights the compliance risks associated with completing the forms, the organizational structure of the provider or supplier, the disclosure requirements initially and ongoing, the impact on billing and cash flow, what resources are available to assist you through the process, the penalties for falsifying information and certification statements being attested to, just to name a few, so you avoid mistakes that can freeze payments for services you’ve already performed and succeed the first time you file your initial enrollment. Topics covered in this session include:
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Timeframes for submission of CMS-855 forms
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Reimbursement effective date dependencies for certified providers/suppliers
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Effective date of billing privileges for physician/groups/NPPs
10:30 a.m. – 11:00 a.m.
Networking Break with Exhibitors
11:00 a.m. – 12:15 p.m.
I&A/PECOS & NPPES Updates
David Zetter
Master the Identity & Access management system to request surrogacy on behalf of providers. Plus, we’ll clarify how Delegated Officials and Authorized Officials take on different meaning in performing enrollment vs. acting as a surrogate.
12:15 p.m. - 12:30 p.m.
Q&A
12:30 p.m. – 1:30 p.m.
Networking Lunch with Exhibitors
1:30 p.m. - 2:30 p.m.
CAQH ProView
Hassaan Sohail
With direct access to CAQH experts you will learn about the industry’s standard and trusted source for self-reported provider data. CAQH ProView continues to be the premier tool for submitting credentialing information and is increasingly being used by health plans to update network directories. You will leave with answers to the most frequently asked questions, including how to prepare for new attestation requirements, as well as how to avoid common errors when completing a CAQH ProView application. The session will conclude with a preview of how CAQH ProView is positioned to reshape the healthcare industry’s approach to provider data.
2:30 p.m. - 3:00 p.m.
CAQH Q&A
Hassaan Sohail
3:00 p.m. – 3:30 p.m.
Networking Break with Exhibitors and PECOS Station
3:30 p.m. – 5:30 p.m.
Provider-Based & §603 of the Bipartisan Budget Act of 2020 – Payment Reductions for Certain Off-Campus Hospital Departments
Dennis Grindle
Planning to relocate hospital outpatient departments? Be careful! With the passage of §603 of the Bipartisan Budget Act of 2020 on November 2, 2020, relocations of hospital outpatient departments from one address to another or the establishment of new off-campus provider-based hospital outpatient departments on or after November 2, 2020 could mean unintended payment reductions to your hospital. This was effective January 1, 2020 and continues through 2020. It’s determined by how you complete your Medicare enrollments. Remember, Medicare enrollment forms can impact how a provider/supplier is ultimately paid for its services.
5:30 p.m.
Day 1 Adjourns
**Agenda and Speakers Subject to Change**
Who should attend?
- Enrollment Managers
- Credentialing Specialists
- Billing Department Managers
- Payer Relations Managers
- Office Managers
- Administrators
More than 3 hours
of dedicated Q&A
Look for the QA icon for opportunities to get your challenges solved with direct access to the top enrollment and credentialing consultants in the country!
3+ hours of dedicated Q&A
directly with experts
Step-by-step
beginning to end
Online PECOS vs. print
enrollment demonstration side-by-side
Agenda Day 2
Tuesday, September 18
7:00 a.m. – 8:00 a.m.
Registration/Continental Breakfast with Exhibitors
8:00 a.m. – 10:15 a.m.
2020 Medicare Enrollment Regulations Updates
Dennis Grindle and Gretchin Heckenlively
Be the first to know of the latest changes and anticipated roll out of proposed Medicare enrollment forms, enrollment-tied Program Integrity Manual changes, unannounced site inspections and license verification, enrollment moratoriums and more. Plus, find out what’s next in CMS’s revalidation push and clarity on recent changes to enrollment processes (from Ordering & Referring to Surrogacy).
10:15 a.m. – 10:30 a.m.
Q&A
Dennis Grindle and Gretchin Heckenlively
10:30 a.m. – 11:00 a.m.
Networking Break with Exhibitors and PECOS Station
11:00 a.m. - 11:45 a.m.
Medicare Revalidations
Gretchin Heckenlively
CMS is proposing new regulations that implement additional provider enrollment provisions of the Affordable Care Act to help make certain that entities and individuals who pose risks to the Medicare program and beneficiaries are kept out of or removed from Medicare for extended periods. Find out how to protect yourself from debilitating penalties caused by bad actors who compromise program integrity.
11:45 a.m. - 12:15 p.m.
Q&A
Dennis Grindle and Gretchin Heckenlively
12:15 p.m. – 1:15 p.m.
Networking Lunch with Exhibitors
1:15 p.m. – 2:30 p.m.
Hidden Compliance Risks within the Medicare Billing Privilege Process
Dennis Grindle
Enrollment and billing are more closely connected than you might think! Dennis explains exactly how the two are related and offers best-practice sleuthing tips that will keep your practice safe from surprising and costly vulnerabilities and liabilities and ensure you remain 100% compliant. Areas of risks covered in the session include: Reassignment rules, “Incident to” rule, Carrier Jurisdiction rules, Site-of-Service rules, Three Day Payment Window rules.
2:30 p.m. - 3:00 p.m.
Q&A
Dennis Grindle and Gretchin Heckenlively
3:00 p.m. – 3:30 p.m.
Networking Break with Exhibitors and PECOS Station
3:30 p.m. – 5:30 p.m.
How to Complete the CMS-855B
Dennis Grindle and Gretchin Heckenlively
Enroll or revalidate completely, accurately and efficiently as Dennis thoroughly explains each of the 17 sections of the CMS-855B form, pointing out common errors to avoid and clarifying what's being asked, including:
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Practice location information
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Organizational and individual control sections
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Billing agency information
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Special requirements section
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Statements, attestations & supporting document requirements
5:30 p.m. – 6:30 p.m.
Networking Reception with Exhibitors
6:30 p.m.
Day 2 Adjourns
**Agenda and Speakers Subject to Change**
Who should attend?
- Enrollment Managers
- Credentialing Specialists
- Billing Department Managers
- Payer Relations Managers
- Office Managers
- Administrators
3+ hours of dedicated Q&A
directly with experts
Step-by-step
beginning to end
Online PECOS vs. print
enrollment demonstration side-by-side
Agenda Day 3
Wednesday, September 19
7:00 a.m. – 8:00 a.m.
Continental Breakfast with Exhibitors
8:00 a.m. – 9:30 a.m.
How to Complete the CMS-855I
Dennis Grindle and Gretchin Heckenlively
Physicians, physician assistants, physical therapists and other NPPs will discover how to successfully complete each required section of the 28-page CMS-855I and the many screens within the PECOS equivalent online enrollment process. You’ll learn how to complete when using moonlighting residents, how to complete to reactivate a practitioner’s enrollment, to revalidate or change information and much more.
9:30 a.m. - 10:00 a.m.
Q&A
Dennis Grindle and Gretchin Heckenlively
10:00 a.m. – 10:30 a.m.
Networking Break with Exhibitors and PECOS Station
10:30 a.m. – 11:00 a.m.
How to Complete the CMS-855R for Reassignment of Medicare Benefits
Gretchin Heckenlively
Learn how to complete the new CMS-855R that was required for use on June 1, 2020.
11:00 a.m. – 12:00 p.m.
How to Complete the CMS-855A
Dennis Grindle and Gretchin Heckenlively
Learn which providers are required to complete the CMS‐855A and the information that must be included on the form.
12:00 p.m. – 1:00 p.m.
Networking Lunch
1:00 p.m. – 1:45 p.m.
How to Complete the CMS-855S for DME Suppliers
Dennis Grindle and Gretchin Heckenlively
Apply what you’ve learned thus far about acronyms, definitions and more to ensure quick and speedy completion of sections in the 38-page CMS-855S application appropriate for your organization, plus view the corresponding online PECOS pages.
1:45 p.m.
Conference Adjourns
**Agenda and Speakers Subject to Change**
Who should attend?
- Enrollment Managers
- Credentialing Specialists
- Billing Department Managers
- Payer Relations Managers
- Office Managers
- Administrators
More than 3 hours
of dedicated Q&A
Look for the QA icon for opportunities to get your challenges solved with direct access to the top enrollment and credentialing consultants in the country!
3+ hours of dedicated Q&A
directly with experts
Step-by-step
beginning to end
Online PECOS vs. print
enrollment demonstration side-by-side
Meet our Enrollment Experts and Specialists
Dennis Grindle, CPA
Health Care Consulting Partner
Dennis K. Grindle, CPA, Partner in Health Care Consulting, has been with the consulting and accounting firm of Seim Johnson, LLP, since 1989 and prior to that time he had two years of tax consulting experience with a national accounting firm and four years of physician reimbursement management experience with a hospital-owned physician management group.
Dennis focuses on the following services: Medicare provider enrollment (Form CMS-855 completion and compliance consulting) issues; Medicare provider-based issues; Medicare reimbursement physician and non-physician practitioner Medicare billing issues, and other such issues.
Dennis has lectured on Medicare provider enrollment (Form CMS-855) issues, Medicare provider-based issues, physician and non-physician practitioner reimbursement matters, corporate compliance plans, physician compensation plans, and other practice management issues at a local, state and national level.
Dennis frequently does presentations on provider enrollment and reimbursement issues with representatives from the CMS Central Office, CMS Regional Offices, Medicare contractors, state agencies, and various other payors. He also serves on the CMS Central Office PECOS focus group and is a member of several professional and healthcare associations.
Gretchin S. Heckenlively, CPA, FHFMA
Health Care Consulting Partner
Gretchin is a CPA and Partner in Health Care Consulting division at Seim Johnson, LLP. She graduated from Doane College in May 1997 with a Bachelor of Science Degree in Accounting and Finance. Gretchin joined the firm in 1997 in the HealthCare Audit Division providing audit and Medicare/Medicaid cost report services on over 100 engagements. Gretchin left in 2006 to pursue an opportunity as the Chief Financial Officer of a critical access hospital. There she was able to gain valuable experience in both the financial and clinical arenas of a hospital.
Gretchin rejoined the firm in 2010 and since that time, she has been able to bring the knowledge and understanding of working in the healthcare environment to the consulting division. Gretchin’s focus since rejoining the firm has been on Medicare and Medicaid provider enrollment, Medicare provider-based issues and reimbursement.
Gretchin has given many presentations on a wide range of healthcare and not-for-profit related topics at a local, state and national level and is currently serves on the CMS Central Office PECOS focus group. In addition, she is an active member of Healthcare Financial Management Association (HFMA) and is a past President of the Nebraska Chapter. Currently, she is serving as the Treasurer of HFMA Region 8.
David Zetter,
PHR, CHCC, CHCO, CPC, COC, PCS, FCS, CHBC
David is a consultant with Zetter Health Care Management Consultants. He has provided practice management, coding and compliance training to medical organizations for more than 25 years. David is also a nationally recognized enrollment expert and CMS regularly solicits his feedback in their PECOS user focus groups. David is a member of the Board of Directors for the National Society of Certified Health care Business Consultants and is a certified health care business consultant (CHBC). He is also a certified professional coder (CPC) for physician practices, hospitals and facilities, and a certified health care compliance consultant (CHCC). David is also a member of the American Health Lawyers Association, the Medical Group Management Association and the Health care Financial Management Association.
Hassaan Sohail
Product Manager, CAQH
Hassaan Sohail is a Product Manager at CAQH, a non-profit alliance focused on reducing administrative waste in the health care Industry. As an industry expert on provider data, Hassaan is part of the product team responsible for improving CAQH ProView. With emerging regulations around provider directory data, Hassaan spends much of his time focused on how health plans can publish the best directory information without burdening the provider community for data confirmation requests.
**Agenda and Speakers Subject to Change**
Exhibitor and Sponsorship Opportunities
We are pleased to invite you to exhibit at DecisionHealth’s National Provider Enrollment Forum, the only event of its kind dedicated to provider enrollment and credentialing training for healthcare professionals spanning an array of provider settings.
Everything healthcare professionals thought they knew about enrollment and credentialing is changing, from the massive, multi-year Medicare revalidation effort to online PECOS and Universal Provider Datasource enhancements and updates. Providers send their employees of all experience levels for four full days of intensive training from top enrollment experts to help solve their Medicare and private payer enrollment challenges. An in-depth discussion and demonstration about the next generation ProView changes that launched in 2020 will be available for attendees and exhibitors.
Partnering with DecisionHealth is a unique opportunity to showcase your products and services, build relationships, and educate our conference attendees, which not only benefits you, but brings value to our customers.
Exhibitors will reach:
- Enrollment Specialists
- Credentialing/Licensure Specialists
- Revenue Cycle Manager
- Billing Department Managers
- Payer Relations Managers
- Office/Practice Managers
- Administrators
For information on exhibit and sponsorship opportunities, please contact Amy Roadman.
For pricing and customized plans contact
Amy Roadman
Sponsors & Exhibitors
Sponsors
Exhibitors
CAQH
Intellisoft Group
Symplr
Please contact the event manager Marilyn (marilyn.b.turner(at)nyeventslist.com ) below for:
- Multiple participant discounts
- Price quotations or visa invitation letters
- Payment by alternate channels (PayPal, check, Western Union, wire transfers etc)
- Event sponsorships
NO REFUNDS/TRANSFERS ALLOWED ON REGISTRATIONS
Prices may go up any time. Service fees included in pricing.
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