Home Health & Hospice Week

Warning: Claims related to docs not enrolled in PECOS may be at risk. You should add a few steps to your physician verification process -- but that won't guarantee your claims are safe from take-backs down the road. Home care industry representatives were full of questions regarding PECOS enrollment requirements for referring physicians at the July 7 Open Door Forum for home care providers. That's because the mandate for referring physicians to be enrolled in Medicare's Provider Enrollment, Change and Ownership System took effect July 6. The Centers for Medicare & Medicaid Services issued a notice saying it wouldn't yet implement systematic edits that automatically reject claims lacking PECOS-enrolled physicians' National Provider Identifier numbers. But in the notice, CMS didn't rule out future recoupments for such claims (see Eli's HCW, Vol. XIX, No. 25, p. 194). CMS reinforced that uncertainty during the call that drew more than 700 participants. "I understand [...]