PECOS AND Medicare I & A Enrollment Thrashed Out For Your Practice

Posted by KUNAL JAIN on Jul 30 2015

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Internet-based Provider Enrollment, Chain and Ownership System (PECOS) has been established by CMS as an alternative to the paper (CMS-855) enrollment process. It can be used as your one-stop shop for enrollment, registration and revalidation of your Medicare account for your practice. Besides this big benefit, enrolling properly will ensure that you DO NOT incur any financial loss unnecessarily.

Steps You Can Take To Prevent Claim Denials Due To Inappropriate Credentiling In Medicare PECOS System

  1. Enroll into Internet-based PECOS using Your NPI user name and password
  2. Verify Your Enrollment and Revalidate if required.
  3. Update Information In PECOS if changes happen within your practice like address or bank account.
  4. Revalidate ( Recredential) Information For Your Practice and yourself in Every 5 Years

Take a deep breath. It is not hard to accomplish these steps. We know you are a busy practitioner with patients and their welfare in mind – so we will walk you through all these steps (with screenshots in the pdf here from CMS) so, it will be a breeze to enroll In PECOS, make subsequent changes in Medicare Enrollment and Revalidating Medicare & PECOS I & A every 5 years. Ready? 

Step-1: Make Sure You Are Enrolled In PECOS.

  1. Access Internet-based PECOS by using NPPES User Id & Password. Also have your NPI available. If you need assistance in this regard, you may contact the NPI Enumerator at 1-800-465-3203 or [email protected].
  2. Complete, review, and submit an electronic enrollment application at https://pecos.cms.hhs.gov
  3. Complete a 2-page Certification Statement for each enrollment application you submit – you will find this at the end of application.
  4. Mail this original signed Certification Statement along with supporting documents to the Medicare contractor. Please note that Medicare contractor will not process an Internet enrollment application without the signed and dated Certification Statement.

 

Step-2: Verify Your Enrollment:  

If you are uncertain about your or Provider enrollment in PECOS, follow these steps to determine the status of your PECOS record -

  1. Access Internet based PECOS
    • using user ID and password must be obtained via the National Plan & Provider Enumeration System (NPPES) / PECOS Identification and Authentication system (I&A)
  2. Log in
    • PECOS will then find the individual practitioner’s record(s) that matches the entered user ID and password.
  3. Browse PECOS to see your Medicare enrollment information.
    • Upon Log In, once individual practitioner record is found, another welcome page will display with the individual practitioner’s name.
    • Click the [MY ENROLLMENTS] button under ‘Manage Medicare & Account Information’.
  1. Check if your record exists.
    • The “My Enrollments” page will display. Here you can see your status if your record is in the PECOS or you are NOT currently enrolled in PECOS-

 

POSSIBILITY 1- If the individual practitioner record is in PECOS:

  1. The individual practitioner’s name and NPI will display under “Existing Associates (Regardless of the final status of your enrollment(s), such as Approved or Voluntary Withdraw, etc.),
  • If an individual practitioner is enrolled as a physician or non-physician in PECOS, he/she will be able to view all their existing enrollments in PECOS by clicking the “VIEW ENROLLMENTS” button.
  •  Each enrollment will display the individual practitioner’s specialty type, the corresponding enrollment state, and the current status of the enrollment.

 

POSSIBILITY 2 - If the individual practitioner is NOT currently enrolled in PECOS:

  1. The “Existing Associates” section will display the following message:

           “There are no Associates currently present for the details provided.”

 

POSSIBILITY 3 - If an individual practitioner is not enrolled in PECOS as a physician or non-physician, but exists in PECOS in another capacity (e.g. an Owner or a Billing Agency)

  1. The “My Enrollments” page will not display the enrollment records associated with the individual. You will again get the screen with same message:

            “There are no Associates currently present for the details provided.”

You are now ready to enroll in PECOS effortlessly. I have also listed down some resources for you to refer to, in case you need them. Don’t miss our next post in the series, we will highlight the importance & steps of Updating & Revalidating your record in PECOS plus EXPERT TIPS on how ignorance of PECOS can strap your practice of cash.

Although we have thrashed out these steps for you to Enroll & Verify in PECOS with confidence, if you prefer to work with us at Practice Forces – we are just a call away.

Remember Our Goal Is To Avoid Any Cash Flow Loss For Your Practice

 

If you need help with getting onboard with the new requirements, hire us for the best service & nominal fee of $1250. Place your order Now!

 

Have question? Call us at 866-634-6327 or drop us a quick note at [email protected]

Sources & Resources:

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/InternetbasedPECOS.html

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/Instructionsforviewingpractitionerstatus.pdf

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/downloads/SpecialEnrollmentFactsheetinfrequentPhysicianReimbursement.pdf

 

Topics: PECOS, Enrollment, Medicare, healthcare costs

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