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Billing Co. Can't Fill Out PECOS Form on Doc's Behalf

Published on Mon Jan 12, 2009

Practitioners must personally fill out online form.

Most practices that participate with Medicare Part B are delighted about the opportunity to complete enrollment forms using the Internet-based Provider Enrollment, Chain and Ownership System (PECOS). But the PECOS process differs from the paper-based enrollment that most practices are accustomed to.

Read on to get a few highlights of PECOS that CMS officials revealed during a Jan. 13 open door forum on the topic.

.If you've grown accustomed to a designated credentialing specialist in your practice or at an outside consulting group filling out your credentialing forms for you, it's time to get in a new groove. A designated representative of the practice can still enroll in Medicare using the paper form (the CMS-855), but only the actual practitioners can apply for enrollment over the internet via PECOS. CMS chalks this requirement up to a security issue.

Good to know: CMS advises that the online application must be completed personally by the provider. CMS' security policies state that a provider will be suspended from the Medicare program if CMS becomes aware that the provider shared his or her username and/or password with anyone or the application was completed by anyone other than the provider.

.Your physician or nonphysician practitioner should gather all information he or she needs and set aside about 30 to 40 minutes to enroll in the system and fill out the PECOS?forms online,the CMS reps said during the call.

. After the practitioner completes the online PECOS form, he or she must mail in a signed certification statement -- this is essential to establish the date of filing.

. You may not submit your enrollment application more than 30 days before the physician starts at your practice.For instance, if he is scheduled to start working at your practice on July 1,don't apply for credentialing until June 1 or after that date.

. CMS will not make available screenshots of the PECOS enrollment forms for practices who hoped to review the forms ahead of time.

When your practitioner puts his or her information into the system, it will alter which forms and/or fields he or she needs based on the physician's and practice's specific circumstances. Therefore, there is no way to know exactly which forms your physician will encounter when actually applying.To read more about PECOS, visit www.cms.hhs.gov/MedicareProviderSupEnroll/02_Internet-basedPECOS.asp

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