Are your providers currently enrolled in the Medicare PECOS system? Are the providers who regularly refer patients to your clinic enrolled?
PECOS: Provider Enrollment, Chain and Ownership System
Many providers are still unaware of the PECOS system, the need for enrollment, and the negative impact that failure to enroll could have on their practice.
Although enrolled in Medicare, many providers do not have current enrollment records in Medicare. A current enrollment record is one that is in the PECOS and also contains the provider’s National Provider Identifier (NPI).
Any provider who is enrolled in Medicare but has not updated their enrollment record since November 2003 is urged to update their record now in order to establish a current enrollment record in PECOS.
Impact: Failure to do so could result in significant cash flow problems due to denied claims.
Beginning January 3, 2011, claims will be denied if the submitting provider or the referring provider listed on the claim are not enrolled in PECOS.
A handy tool is available from CMS which allows you to check to see if your providers are currently enrolled in PECOS. To check your doctor’s eligibility, download the list and then use the look-up tool on the Adobe tabs (binoculars), then type in your provider or referring provider’s NPI number for the search. If it shows, they are registered in PECOS. Download available here: http://tinyurl.com/ykygzpx
If you find that you are not registered in PECOS, you will find complete instructions here: http://tinyurl.com/y8799hp
Virginia College Healthcare Reimbursement Services is committed to helping our clients stay abreast of this constantly changing industry with no interruptions to cash flow. We are here to help!