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Format: On-Demand Webinar
Presenter: David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP
Time: You can access the webinar anytime
Duration: 60 minutes
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When onboarding a new physician into your practice, your process must be flawless. The slightest mistake can result in significant reimbursement delays or worse payer rule violations.

There are a million details you must get right the first time. Failure to do so can significantly delay your new provider from being eligible to see patients and get paid. Even simple errors can get your set-up/ transfer documents thrown out. Then you’ll be required to go through the entire process all over again.

It is vital that your new physician starts to see patients and get paid as soon as possible. You can make this happen by attending this online training presented by practice management expert, David J. Zetter, PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP.

David will walk you through each step of creating, implementing, and optimizing your new provider onboarding process. You can make your onboarding process more efficient and accurate. You can speed up your billing process and get paid more quickly. David’s upcoming online training will give you the proven tactics you need to make this happen.

Even an innocent mistake during the provider onboarding process can have profound financial implications for your practice. You must get it right the first time to avoid difficult-to-fix payer setup errors that will significantly delay reimbursements. Everyone at your practice (including the patients) depends on you to get your new doctor up and running as quickly and efficiently as possible and this upcoming online training can show you how.

By attending this expert-led physician onboarding training, you’ll receive proven, step-by-step tactics that you can put into action immediately.

Learning Objectives

  • Is it better for a new provider to bill under their NPI or your practice’s?
  • When is it possible to start credentialing for a new doctor before they arrive?
  • How can a new physician see patients before they are fully credentialed?
  • When and how must new doctors re-attest with PECOS and CAQH?
  • When can a new provider bill under another physician’s name at your practice?
  • How can you speed up a new provider’s Medicare enrollment transfer?
  • When is filing for temporary hospital privileges worth your time?
  • Can a new physician bill for services under the supervision of another provider?
  • If a new provider’s documents are not all in, can they still bill for their services?
  • How can you get your payer plans to approve a new physician more quickly?
  • Build an enrollment and credentialing process that tracks every step
  • Know your options and how to track the communications and process
  • Know your options for communicating with payors
  • Know what to do to hold the payor accountable for their actions and responsibilities to the process
  • Access state laws and regulations that protect the provider with managed care enrollment and credentialing

Areas Covered in the Session

  • Enrollment and credentialing process
  • Planning and process for onboarding new providers
  • When are you aware of a new provider being hired?
  • When do you receive information and documentation from provider?
  • Do you have all access to the provider and anyone that has the information?
  • How long after hire is first payor communicated with?
  • Do you have control over this process?
  • Do you have checklists and capabilities to determine when you have received what you requested?
  • How do you follow-up with payors?
  • How many people are involved to make this process work?
  • Are you aware of any issues with the process?
  • Setting Up for Success
  • Authorization
  • Checklists
  • Gathering & Compiling
    • Tentative start date dependent upon credentialing status
    • Communication of IDR to provider
    • What is contained in IDR and why?
    • Structured and organized communication and reference documents
    • Communicate submission timeline to provider
    • IDR submission process and responsibility
    • How to communicate/submit
    • Communicate & enforce expectations
    • Maintain copies of everything
    • Track time to evaluate for efficiencies and improvement
  • Information & Documentation Request
  • The Process
    • When does the process start?
    • Determining when receipt of IDR is complete
    • Receipt of everything a payor could ever request
    • CAQH creation and build-out
    • What is process for initiating payor communication?
    • Know what payors for what services
    • Know the state regulations and payor requirements
    • Legislation, rules and regulations protect you and your provider/client
    • Forgetting the details
    • Determining that each step of the process completed correctly and thoroughly
    • Process for communicating status to client/provider/practice
    • NPPES, I&A, PECOS, Medicaid and CAQH
    • Provider directory updates
  • State Regulations
  • Credentialing Tips

Suggested Attendees

  • Providers & physicians
  • Administrators and office managers
  • Billing
  • Credentialing staff
  • Owners
  • Healthcare CEOs
  • Healthcare CFOs
  • Healthcare COOs
  • Billing staff and companies
  • Physicians and other providers
  • Healthcare consultants
  • Compliance Officers
  • Physicians
  • Nurses
  • Practice Manager

About the Presenter

David J. Zetter, PHR, SHRM‐CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP, CMHP, is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 30 years of operational and healthcare experience. David is nationally recognized for his presentations and expertise. He is well-versed in regulatory requirements, revenue cycle management, credentialing and contracting, compliance, coding and documentation. He is considered an expert on Medicare, not only by his clients but his consultant colleagues across the country. He has evaluated existing ambulatory care facilities and practices with respect to patient flow, operations, marketing, fee structures, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. His activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types, including coding and broad‐based regulatory issues. David has also conducted chart audits on behalf of Medicare contractors and Blue Cross/ Blue Shield early in his career, so he has knowledge of what the expectations are from the payers. David’s firm works with healthcare professional clients and facilities coast to coast, in all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, governance documentation, policy and procedure development and implementation, credentialing and contracting, human resources staffing and management, compliance, coding and chart reviews, physician education and many other areas. David has helped to maximize both profitability and reimbursement of physician practices, facility and ambulatory practices, re‐engineered operational and human resources, and addressed coding and billing issues for providers to curtail fraud, abuse, kickback, OIG, and IRS issues. He is also an original member of CMS’ PECOS Power User Group, CMS Compliance Focus Group and MIPS Design Lean Work Group which provides feedback and recommendations to Medicare’s Center for Program Integrity and Provider Enrollment Operations Group on design and improvements to the PECOS enrollment environment, as well as, NPPES and MIPS and conducts beta testing of the EHR/ HITECH user interfaces and environments at the request of the Office of e‐Health Standards & Services Director. David is also on the CMS contracted team awarded the PECOS 2.0 contract to rebuild PECOS from the ground up. David has conducted practice management, human resource, coding and compliance education and seminars in many states over the past twenty‐five years. David speaks often on a variety of practice management subjects at hospital residency programs, the National Society for Certified Healthcare Business Consultants, the Medical Management Group Association, the American Academy of Professional Coders, AHIMA, Florida Institute of Certified Public Accountants, Florida Medical Society, many other venues and is often called upon by the MGMA, HFMA, DecisionHealth, Part B News, Part B Insider, and many others, to conduct audio conferences and webinars. He has been published in Medical Economics and interviewed and quoted in many publications including Report on Patient Privacy and Report on Medicare Compliance.

Snippet From Our Previous Session

Course Content

You can access all the webinar materials after successful payment

  • Webinar Link + Handouts PDF
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