Understanding Payer Enrollment
- Tuesday
- April
- 08
- 2025
Tammy West Overview:
Payor enrollment can delay the onboarding process for months, leading to issues with provider satisfaction, patient satisfaction, revenue generation, access to care and, ultimately, patient safety. This presentation will review payor enrollment’s impact on revenue cycle, review the process for enrollment with government and commercial payors, and discuss the most common reasons for delays in payor enrollment and steps to take to avoid those delays.
Why you should Attend:
- Stop revenue leakage by enrolling providers correctly the first time
- Become more self-confident in your interactions with health plans
- Gain the knowledge to perform provider enrollment services correctly
Areas Covered in the Session:
- Define payor enrollment and revenue cycle
- Discuss payor enrollment’s impact on revenue cycle
- Review process for enrollment with government and commercial payors
- Discuss most common reasons for delays in payor enrollment and steps to take to avoid delays
Who Will Benefit:
- Medical Staff Coordinators
- Office Managers
- Physician Practices
- Business Offices Provider enrollment Specialists
Speaker Profile
Tammy West , MHA/ED, CPMSM, CPCS is Sr. Director, Professional Services for The Hardenbergh Group. She has 27 years’ experience in healthcare administration and customer service and 17 years in Medical Staff Services. Tammy specializes in CVO operations, customer service, provider credentialing, provider enrollment, quality analysis, quality improvement, quality auditing, delegation audits, and policy and procedure creation and implementation. She has extensive experience with CMS, TJC and NCQA requirements for provider credentialing and medical staff services.
Tammy leverages her vast professional experience to identify and place experienced, qualified MSPs to help clients fill temporary vacancies, supplement existing staff during peak workloads, assess and improve operational efficiency, prepare for regulatory surveys and audits, pursue NCQA accreditation and certification, and more.
Prior to joining The Hardenbergh Group, Tammy was a consultant and independent contractor for hospitals, health systems, CVOs, locum companies and private practices across the United States. She has vast experience as an MSP, including credentialing specialist, provider enrollment specialist, medical staff coordinator, Medical Staff Manager, and CVO Director.
Tammy was a CVO Manager where she was responsible for creating and implementing policies and procedures for a new corporate CVO. During her tenure, the CVO achieved NCQA accreditation and delegated credentialing status with commercial payors. Other related roles included working as a Customer Service supervisor for a medical equipment company, a quality auditor for an NCQA certified managed care company and an Adjunct Instructor teaching medical office systems classes.
Tammy has a BS in Human Services Management and a Master’s in Healthcare Administration with a minor in Education. She is a member of the North Carolina Association Medical Staff Services and the National Association Medical Staff Services.