An Introduction to Payor Enrollment Blog Feature
Donna Goestenkors

By: Donna Goestenkors on January 23rd, 2015

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An Introduction to Payor Enrollment

Medical Service Professionals | Payor Enrollment | Credentialing | Payor

If you build it, they will come! That’s exactly what the Texas Society for Medical Services Professionals (TSMSS), symplr and Team Med Global Consulting did. Their collaboration led them to the first-of-its-kind educational webinar series focused on provider enrollment and the specialists in the field. The first session, of three, Introduction to Enrollment was held on Wednesday, January 14th with more than 200 participants. Over the years, these professionals have been working with minimal guidance, little to no resources and having to do what many Medical Staff Service Professionals (MSP) colleagues have done – learn from the school of hard knocks! We all understand the challenges this practice creates (i.e. errors, inconsistently applied practices, inefficiencies, non-compliance and slow or no reimbursement). We want to help you change this!

Medical Service Professionals, Payor Enrollment, CredentialingThere’s a critical need for education, resources, consulting and guidance in payor enrollment. The confusion begins with the name itself, credentialing at the hospital vs credentialing with payors or provider enrollment, and continues with whom the work is performed for as well as the information necessary to complete the tasks. Credentialing and payor enrollment have unique requirements, forms and regulations creating disparately different disciplines. That said, when these two areas collaborate and work together to onboard providers – it can avoid enrollment delays for both groups. There is a direct correlation between increased revenue when enrollment occurs in tandem with the credentialing process. The quicker physicians and practitioners are granted privileges, enrolled in the various health plans and oriented to that organization’s culture and requirements, the faster and often times, the greater their reimbursement.

In today’s “credentialing world",there’s an inherent need for those working with, aggregating and using the same medical staff data to work collegiately. Some MSPs are already performing payor enrollment work, many have expressed an interest in expanding into enrollment while those specializing in enrollment desire growth of their roles and responsibilities as well. Throughout this process, we will work to lead the industry, push for change and provide education and resources to those who wish to take advantage of it.

To learn more about payor enrollment, click here to register for Session 2, “Enrollment 101” to be held on Wednesday, February 11th and Session 3, “Enrollment 201” to be held on Wednesday, March 11th. Help us be a part of the change!


About Donna Goestenkors

Donna is a full time healthcare consultant, speaker, author, educator, and mentor serving the Medical Staff Services industry for over 40 years. Her diverse project experience includes assignments in every work environment and rapport building among all levels of professional and executive staff. Donna is a past President of NAMSS and her client work covers all of the industry's environments from Healthcare Systems to critical access hospitals.