Plus: One carrier denies 75 percent of long-stay hospice claims. The transition from paper Medicare registration to electronic enrollment has not been entirely seamless, but once you've got an enrollment record in PECOS and you register in the IACS system, you may think your work is done. Think again. To access certain types of online data about your practice, including your Physician Quality Reporting System (PQRS) reports, you'll require an IACS (Individuals Authorized Access to the CMS Computer Services) account. And then once you're registered in IACS, you'll need to log back in every 180 days or more often, or else CMS will automatically disable your account. That's the word from CMS's November document, "IACS User Guide for CMS Communities," which profiles everything you need to know about being an IACS user. The guide also reinforces the fact that you must certify your IACS account annually, and the system will email you 45 days before your due date to ensure that you don't miss the certification process. To read the IACS Guide, visit www.cms.gov/MAPDHelpDesk/downloads/IACS_User_Guide_for_CMS_User_Communities_2010_03.pdf.