Navigating Medicare and Medicaid Managed Care Enrollments in 2024

The process of enrolling with Medicare and Medicaid Managed Care as a provider/organization can be incredibly tedious and time-consuming. The number of new Medicare and Medicaid enrollment applications continues to decline due to the enormous complexities surrounding enrollment application requirements. The cost of getting these enrollment application submissions wrong can have systemic consequences on an organization, including cash flow delays, credentialing issues, coding issues, claims backlogs, denial management issues, patient satisfaction, and even impact quality scores.

In 2024, Medicare opened the enrollment gates for new mental health providers (MFTs and MHCs) that had previously been excluded from providing services to Medicare beneficiaries.  In today’s webinar, we discuss the submission options, which providers are eligible for Medicare and Medicaid enrollment, each enrollment type, how to navigate the enrollment process, key terminology, what ancillary documentation is needed with enrollment submission, applicable fees, linkage issues with PTAN numbers, most common errors, and best practice tips for successfully completing the Medicare and Medicaid enrollments in 2024.

Learning Objectives:-

• Understand the CMS 855 enrollment submission process for 2024
• Recall CMS 855A, 855B, 855I Application requirements for 2024
• Recall the most complicated sections on the 855 applications for 2024
• Recall strategies to complete 855 forms accurately for 2024
• Recall ancillary documentation required with 855 enrollment submissions for 2024
• Avoid common rejections and errors with 855 form submissions
• Recall best practice tips for 855 form submissions for 2024

Areas Covered in the Session:-

• Dissect the various Medicare and Medicaid enrollment types in 2024
• Outline a sample workflow for completing Medicare enrollment
• Outline a sample workflow for completing Medicaid Managed Care enrollment
• Review enrollment forms for Medicare and Medicaid
• Discuss the most challenging Medicare and Medicaid enrollment sections for 2024
• Discuss strategies to complete the Medicare and Medicaid enrollment forms accurately for 2024
• Review process of reassigning Medicare benefits to organizations for 2024
• Review the ancillary documentation required with Medicare and Medicaid enrollment submission for 2024
• Discuss the most common rejections and errors with Medicare and Medicaid enrollment form submissions for 2024

Background:-

All healthcare providers and suppliers are required to complete Medicare and Medicaid enrollment prior to rendering and billing for services. The cost of getting enrollment and participation agreements wrong or missing a deadline can have systemic consequences on an organization, including credentialing issues, coding issues, denial issues, patient satisfaction, and even impact quality scores. 

Why Should You Attend:-

Medicare and Medicaid enrollment applications are tedious, time-consuming, and confusing. Without the proper guidance, a provider can miss important details like application type, NPI type, PECOS requirements, PTAN linkage, taxonomy designations, surrogacy designations, and PAR vs. NON-PAR status.

Who Will Benefit:-

• Professional Fee Medical Coding Specialists
• Professional Fee Medical Billing Specialists
• Professional Fee Medical Auditing Specialists
• Credentialing and Contracting Professionals
• Non-Physician Providers (NPPs) – NP, PA
• Physicians of all specialties
• Operations Leadership
• Practice Administrators
• Office Managers
• Compliance Officers/Committees  
• American Academy of Professional Coders
• American Health Information Management Association
• Medical Group Management Association
• Health Care Compliance Association
• Medical Associations
• Behavioral Health Providers – MHCs and MFTs