Description

Payor enrollment is a time-consuming process that creates barriers to practitioner onboarding and revenue generation. Payor enrollment can delay the onboarding process for months, especially with commercial payors. These delays create issues with provider satisfaction, patient satisfaction, revenue generation, access to care and, ultimately, patient safety.  

This presentation will review the process for enrollment with government and commercial payors, discuss the most common reasons for delays in payor enrollment and steps to take to avoid those delays.

Learning Objectives:-

• Define Payer Enrollment 
• Describe the Process for Enrolment with Government and Commercial Payers 
• Discuss Most Common Reasons for Delays in Payer Enrollment 
• Review Tips to Avoid Delays 
• Understand Timelines Associated with Government and Commercial Payer Enrollment 
• Identify the Role of CAQH in the Payer Enrollment Process 
• Gain Familiarity with PECOS Registration and Functionality 
• Recognize the Impact of Payer Enrollment Delays on Revenue and Provider Satisfaction 
• Understand Key Compliance Considerations Related to Payer Enrollment 
• Review Commercial and Government Plan Requirements in the Enrollment Process.

Areas Covered in the Session:-

• Definition of Payer Enrollment 
• Timelines for Government Payers 
• Review of Federal and State Plan Guidelines 
• PECOS History and Overview 
• Registering for PECOS Access 
• Most Common Reasons for Delays with Medicare Enrollment 
• Tips to Avoid Delays 
• Timelines for Commercial Payers 
• Commercial Plan Types and Requirements 
• CAQH role in Payer Enrollment 
• Commercial Payer Enrollment Process 
• Live Q&A Session.

Who Will Benefit?

• Payer Enrollment Specialists 
• Payer Enrollment Supervisors and Managers 
• Revenue Cycle Personnel 
• Credentialing Specialists 
• Medical Staff Coordinators 
• Medical Practice Administrators 
• CVO (Credentialing Verification Organization) Staff 
• Healthcare Compliance Officers 
• Managed Care Coordinators 
• Provider Relations Managers 
• Practice Managers and Office Administrators 
• Billing and Reimbursement Specialists 
• Revenue Integrity Analysts 
• Quality Improvement and Regulatory Professionals 
• Healthcare Consultants Supporting Credentialing and Enrollment 
• Health Information Management (HIM) Professionals Involved in Provider Data 
• Group Practice Executives and Administrators 
• Hospital Credentialing and Enrollment Teams 
• Provider Network Managers 
• Contracting Specialists in Managed Care 
• Anyone Involved in Provider Onboarding, Enrollment, or Payer Communications.