CMS to Review PECOS Enrollment Process
Provider Enrollment, Chain and Ownership System (PECOS) is the database for all providers of Medicare services.
The Centers for Medicare & Medicaid Services (CMS) will, for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.
While the regulation will be effective July 6, 2010, CMS will not implement automatic rejections of claims submitted by providers that have attempted to enroll in PECOS. However, until the automatic rejections are operational, providers should not see any change in the processing of submitted claims, they will continue to be reviewed and paid as they have historically been reviewed and paid.
Additionally, though CMS is taking a more deliberative approach to using the PECOS enrollment system, the agency will employ a contingency plan to meet the ACA requirement that written orders and certifications are only issued by eligible professionals effective July 1.
If you have enrolled or made a change to your Medicare enrollment since 2003, your information should be in PECOS; however, you should verify that your information is in PECOS by contacting the WPS Provider Enrollment Hotline at: 866-503-7664 or checking the Ordering/Referring Report.
For physicians and non-physician practitioners, there are three basic steps to completing an enrollment action using Internet-based PECOS. Physicians and non-physician practitioners must:
1. Have an NPPES User ID and password to use Internet-based PECOS. For security reasons, physicians and non-physician practitioners should change passwords periodically, at least once a year. Please read the document entitled, "Medicare Physician and Non-Physician Practitioners - Protecting Your Privacy, Protecting Your Medicare Enrollment Record." which is available in the Download section of this page.
2. Go to Internet-based PECOS enrollment page by clicking on the link found in the section titled, "Related Links Outside CMS" (at the bottom of this page) and complete, review, and submit the electronic enrollment application via Internet-based PECOS.
3. Print, sign and date the 2-page Certification Statement for each enrollment application submitted and mail the Certification Statement and all supporting paper documentation to the Medicare contractor within 7 days of electronic submission. Note: A Medicare contractor will not process an Internet enrollment application without the signed and dated Certification Statement. In addition, the effective date of filing an enrollment application is the date the Medicare contractor receives the signed Certification Statement that is associated with the Internet submission.
The Certification Statement must be signed by the physician or non-physician practitioner enrolling or making changes to enrollment information. Signatures must be original and in ink (blue ink recommended). Copied or stamped signatures will not be accepted.
PECOS general website
PECOS info
Internet-based PECOS enrollment
Tips to Facilitate the Medicare Enrollment Process
Physicians, Non-Physician Practitioners and Other Health Care Suppliers Brochure
Ordering / Referring Report – listing of all physicians complying with PECOS
Frequently Asked Questions
Contact information
WPS Medicare Part B
Provder Enrollment
P.O. Box 8248
Madison, WI 53708-8248
PECOS info on WPS Medicare website
For more information, contact Pat Mills, at 800-869-6762.
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