CMS New Medicare Provider Enrollment Rules and Requirements – PECOS, NPPES and I&A


Event Date: 10/18/2023
Time: 1 pm ET | 12 pm CT | 11 am MT | 10 am PT
Duration of the training: 60 Minutes
Location: Online Webinar

Join us to learn the key functions of the Medicare Surrogacy program which allows you to act legally on behalf of providers and suppliers without having to utilize provider login credentials which is in violation of Medicare. This presentation will communicate how the surrogacy program works and with what products it works with. The presentation will provide an overview of how surrogacy works and also Surrogacy allows you to do the following:

  • Efficiently add, modify and terminate providers from your group login
  • Comply with access rules for the PECOS, Identity & Access (I&A) Management System
  • Correctly choose your designation: Authorized/Delegated Official (AO/DO) or Staff End-User
  • Efficiently manage organizational and individual practitioner enrollments in PECOS
  • Successfully use your PECOS login to also manage your provider NPI records within the NPPES system
  • More easily and quickly update practitioner information to avoid Medicare deactivation
  • Easily add, terminate and authorize staff as PECOS users to streamline workflow
Learning Objectives:
  • How you can set up your organization
  • How to set up provider and supplier connections
  • How to add Access Managers and staff to your organization
  • How surrogacy helps you access, update and process Medicare enrollments and updates quicker
  • How it makes your life much easier and keeps you compliant with Medicare regulations
  • Why it is important to utilize the surrogacy program
  • How to streamline enrollment process effectively
Areas Covered in the Session:
  • Setting up your organization
  • Setting up provider and supplier connections
  • Adding  Access Managers and staff to your organization
  • How surrogacy helps you access, update and process Medicare enrollments and updates quicker
  • Medicare regulation and how it makes your life much easier and keeps you compliant
  • Importance of utilizing the surrogacy program
  • I&A Access Rule
  • Creating I&A account to access CMS System such as NPPES and PECOS
  • Management of NPPES & PECOS account
  • Live Q&A session
Suggested Attendees:
  • Credentialing staff
  • Providers
  • Suppliers
  • Enrollment professionals
  • Office managers
  • Consultants
  • Billing companies & staff
  • Healthcare CEOs
  • Healthcare CFOs
  • Healthcare COOs
  • Administrators
  • Physicians and other providers
  • Healthcare consultants
  • Compliance Officers
  • Physicians
  • Nurses
  • Practice Manager
Presenter Biography:

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 payors. 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.