strategic and technical experience

Polsinelli Healthcare Solutions focuses on the development of long-term strategies to address healthcare provider licensure and enrollment processes to ensure business objectives can be achieved in compliance with today’s complex regulatory environment. 

Licensure and enrollment in Medicare, Medicaid and other third-party payer arrangements is essential to the receipt of payment for healthcare services. Provider licensure and enrollment involves an arduous process that requires attention to detail and technical expertise which can overshadow day-to-day responsibilities. Ensuring compliance with regulatory requirements for addressing licensure and enrollment issues can prevent significant regulatory penalties, including overpayments and revocation of enrollment privileges.


Licensure and Enrollment Solutions

Polsinelli Healthcare Solutions consultants provide tailored solutions to meet each provider’s licensure and enrollment needs, including:

  • Developing high-level compliance plans addressing enrollment and licensure operational and compliance risk areas

  • Preparing and completing applications for licensure and enrollment, including working with federal and state officials

  • Accessing PECOS to assess current Medicare enrollment record summaries, assessment of organizational structure, collection of Medicare provider and supplier numbers to track compliance and provide personnel with ongoing compliance advisory and training

  • Advising providers and suppliers on the change of ownership process and the benefits/strategies associated with alternative corporate structures

  • Preparing transaction-related regulatory filings including for Medicare and Medicaid enrollment and licensure, and assisting revenue cycle personnel with claims submission timing and other considerations following transaction consummation

  • Addressing issues in a cost-effective manner to reduce regulatory burdens and achieve strategic business objectives of ensuring essential licensure and enrollment requirements are timely and continuously met