-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Pecos
- Thread starter efuhrmann
- Start date
lseiter
Contributor
Director of billing
I dont either...i am still working on getting it done for our clinic...very frustrait
and to get someone you can undertand on the phone good luck!
I dont either...i am still working on getting it done for our clinic...very frustrait
and to get someone you can undertand on the phone good luck!
MnTwins29
True Blue
Internet-based enrollment
PECOS is simply a means of enrolling or updating a physician's information to CMS via the internet. It is NOT required to be used in order to participate in Medicare. Go to this page on the CMS web site: http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/GettingStarted.pdf and scroll down to page 9 in the FAQ's. It states that enrolling in PECOS is optional. I have seen deadlines for certain information that must be sent from our contractor, but those are for those providers who started the PECOS process and must send information in the next steps by a certain date.
Are these requirements sent from your contractor? Maybe they are contractor-specific?
PECOS is simply a means of enrolling or updating a physician's information to CMS via the internet. It is NOT required to be used in order to participate in Medicare. Go to this page on the CMS web site: http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/GettingStarted.pdf and scroll down to page 9 in the FAQ's. It states that enrolling in PECOS is optional. I have seen deadlines for certain information that must be sent from our contractor, but those are for those providers who started the PECOS process and must send information in the next steps by a certain date.
Are these requirements sent from your contractor? Maybe they are contractor-specific?
Walker22
Guest
PECOS is not optional any longer. In order for Medicare to pay for any radiology or DME, those things must be ordered by a physician enrolled in PECOS. If your physician doesn't ever order any of these things, then I suppose you are ok, but I've never meet a doctor that doesn't order an xray or an MRI at least every once in a while...
MnTwins29
True Blue
Getting scary here..
when I go straight to the horse's mouth, so to speak, and the information I get is incorrect. Walker, do you have the documentation that stated it is no longer optional?
when I go straight to the horse's mouth, so to speak, and the information I get is incorrect. Walker, do you have the documentation that stated it is no longer optional?
Walker22
Guest
I should re-phrase that.. it IS optional. BUT...
If a referring doctor orders a service, but is not registered with PECOS, CMS will not pay for it. I will see if I can find the documentation. Watch this space...
ADDENDUM:
http://www.managemypractice.com/is-your-practice-ready-for-the-60-day-pecos-countdown/
http://physiciancredentialingservic...g/452010-cut-off-for-pecos-online-enrollment/
If a referring doctor orders a service, but is not registered with PECOS, CMS will not pay for it. I will see if I can find the documentation. Watch this space...
ADDENDUM:
http://www.managemypractice.com/is-your-practice-ready-for-the-60-day-pecos-countdown/
http://physiciancredentialingservic...g/452010-cut-off-for-pecos-online-enrollment/
Last edited:
RebeccaWoodward*
True Blue
Although enrolled in Medicare, many physicians and non-physician practitioners who are eligible to order items or services or refer Medicare beneficiaries to other Medicare providers or suppliers for services do not have current enrollment records in Medicare. A current enrollment record is one that is in the Medicare Provider Enrollment, Chain and Ownership System (PECOS) and also contains the physician/non-physician practitioner's National Provider Identifier (NPI). Under Phase 2 of the above referenced CRs, a physician or non-physician practitioner who orders or refers and who does not have a current enrollment record that contains the NPI will cause the claim submitted by the Part B provider/supplier who furnished the ordered or referred item or service to be rejected.
http://www.cms.hhs.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp#TopOfPage
http://www.cms.hhs.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp#TopOfPage
Walker22
Guest
Thanks Rebecca.... I knew I had seen the CMS transmittal, but couldn't put my hands on it...
RebeccaWoodward*
True Blue
Update
MGMA advocacy leads to delay in PECOS requirements for ordering/referring providers
Written by MGMA Government Affairs Department, Washington, DC
Thursday, 18 February 2010 08:09
As a result of the Medical Group Management Association (MGMA) and other associations' advocacy efforts, the Centers for Medicare & Medicaid Services (CMS) will delay implementation of the second phase of modifications to the Provider Enrollment, Chain, and Ownership System (PECOS) regarding ordering/referring providers from April 5 until Jan. 3, 2011. The requirements stipulate that:
All Medicare providers who order or refer for non-durable medical equipment (DME) items or services be enrolled in PECOS or the Medicare carrier's or Part B MAC's (spell out MAC's on first reference) claims system; and
Medicare providers who order or refer DME claims be enrolled in PECOS.
Providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process are not included in PECOS. CMS will reject these provider's claims and therefore deny payment.
Prior to the Jan. 3, 2011, implementation date CMS will:
Continue to place warnings on claims in which the ordering/referring is not enrolled in PECOS;
Update the Medicare Ordering/Referring File;
Remind providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process to submit a new enrollment application either in the paper form or by using Internet-based PECOS.
http://new.mgmanv.org/component/con...irements-for-orderingreferring-providers.html
MGMA advocacy leads to delay in PECOS requirements for ordering/referring providers
Written by MGMA Government Affairs Department, Washington, DC
Thursday, 18 February 2010 08:09
As a result of the Medical Group Management Association (MGMA) and other associations' advocacy efforts, the Centers for Medicare & Medicaid Services (CMS) will delay implementation of the second phase of modifications to the Provider Enrollment, Chain, and Ownership System (PECOS) regarding ordering/referring providers from April 5 until Jan. 3, 2011. The requirements stipulate that:
All Medicare providers who order or refer for non-durable medical equipment (DME) items or services be enrolled in PECOS or the Medicare carrier's or Part B MAC's (spell out MAC's on first reference) claims system; and
Medicare providers who order or refer DME claims be enrolled in PECOS.
Providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process are not included in PECOS. CMS will reject these provider's claims and therefore deny payment.
Prior to the Jan. 3, 2011, implementation date CMS will:
Continue to place warnings on claims in which the ordering/referring is not enrolled in PECOS;
Update the Medicare Ordering/Referring File;
Remind providers who enrolled in Medicare prior to 2003 but have not completed the revalidation process to submit a new enrollment application either in the paper form or by using Internet-based PECOS.
http://new.mgmanv.org/component/con...irements-for-orderingreferring-providers.html
Walker22
Guest
Thanks Rebecca... good to know! I'm going to pretend the dealine is still April 5 and just get it done so I don't have to worry about it!