Complex Enrollment

Description

Collaborative Compliance: Navigating Multi-Agency Regulatory Environments

Provider enrollment specialists often face the challenge of navigating complex regulatory environments involving multiple agencies. Join TMG for strategies to manage compliance across state, federal, and payer-specific requirements. Gain insights into effective collaboration techniques and tools that help maintain compliance without compromising efficiency.

Objectives:
Identify common regulatory challenges faced in multi-agency environments
Describe collaborative strategies to ensure compliance across various regulatory bodies
Explain the use of compliance tracking tools to manage requirements and deadlines

Avoiding Landmines: Navigating Complex Enrollments

Enrollment for providers working across multiple locations – or multiple plans for a single practice – presents unique challenges and heightened risks for unintentional fraud and abuse. Join TMG and delve into best practices that safeguard against billing inaccuracies and compliance breaches, and ensure proper reimbursement.

Objectives:
Identify key challenges and risks associated with complex enrollments
Describe essential strategies to ensure accurate provider enrollment and compliance
Explain how to detect and prevent potential fraud and abuse

Peril Carousel: Provider Enrollment for Multi-Specialty Groups

Multi-specialty groups face unique provider enrollment perils, ranging from payments that are sent to a physician’s primary practice to inadvertently changing a new practitioner’s existing CAQH profile. Learn how to build effective relationships with stakeholders to manage a dynamic environment. Then, discover how to create robust internal processes to identify provider enrollment issues.

Objectives:
Explain the impact of primary and secondary taxonomy codes on payment
Identify solutions that allow groups to operate effectively in multiple geographic locations
Describe how to best utilize national and state credentialing portals used by payers to maintain current information

Scaling Up! Provider Enrollment for Large Health Systems

Timely provider enrollment is the cornerstone of revenue management for large health systems, yet provider enrollment specialists can face challenges gathering complete packages of information from providers. Discover how to scale provider enrollment processes to achieve revenue management goals.

Objectives:
Describe 3 strategies to master varying state requirements
Explain the importance of managing timeline expectations
Identify processes to ensure provider CAQH entries are accurate

Going the Extra Mile: Provider Enrollment Across State Lines

When an insured patient from out of state receives emergency services, payment can fall through the cracks. Join Team Med Global’s provider enrollment team as they explain efficient processes for enrolling a provider after services have been rendered and provide tips on communicating with payers.

Objectives:
Explain payer caveats that allow for post-service enrollment
Identify efficient processes for post-service enrollment
Describe 5 steps to ensure timely payment