Session Details

Name
Provider Enrollment Traps for the Unwary
Track
Billing & Compliance
Date & Time
Tuesday, June 9, 2026, 9:45 AM - 10:45 AM
Location Name
Room 3 & 4
Presentation

Learning Objectives

Name
Provider Enrollment Traps for the Unwary
Description

There have been a number of changes to the provider enrollment process over the last several years including new contractors and stricter enforcement. Whether you are enrolling for the first time or revalidating after decades of being enrolled, suppliers must pay attention to detail and be proactive. Keeping your supplier enrollment file accurate and current is key to your operations because without a valid PTAN, suppliers will not be successful. Not only is your Medicare income affected by a loss of your PTAN, but it can also affect your Medicaid and managed care contacts. The industry is seeing an increase in revocations due to numerous reasons including site inspections. Minor infractions can end up causing major issues for suppliers. This presentation will discuss ways to handle a site inspection to ensure that the supplier’s PTAN isn’t revoked. Additionally, this presentation will discuss the current state of enrollment issues and will provide practical tips on how to respond to denials, revalidations, revocations, and other enrollment actions.

Proposed Learning Objective (1)
Identify the required steps a supplier must take when a PTAN is denied or revoked and outline the appropriate actions to restore compliance and eligibility.
Proposed Learning Objective (2)
Describe the enrollment appeal process for a denied or revoked PTAN and explain at least two supplier rights that apply during the appeal.
Proposed Learning Objective (3)
Identify the required documentation and items needed for a site inspection and explain how to ensure all materials are properly prepared and presented to demonstrate compliance with Medicare Supplier Standards.

CEU and CEC

When applicable, the CEU or CEC credits for each accrediting body are displayed below.

ABC CEU
1.0
BOC 2 CEU
1.25
AARC CEU
1.0
CEAC CEC
1.0
IACET CEU
0.1
Contact Hours
1.0