Tag: PECOS
CMS announces PECOS redesign
January 30, 2023HME News Staff
WASHINGTON – CMS has announced that submitting and tracking Medicare enrollment applications in PECOS will soon get easier and faster. Starting this summer, the agency says PECOS will feature:
A single application for multiple enrollments
Pre-population of data and an application that’s tailored to you
Enhanced capability to add or delete group members
Real-time processing checks and status updates
Re-validation reminders
The...
PECOS preparation pays off, providers say
January 24, 2014Elizabeth Deprey
WASHINGTON - CMS on Jan. 6 officially began denying claims with the names of physicians not enrolled in PECOS, and providers say so far, so good.
“We've been very fortunate,” said Lori Corey, vice president of finance for Waukesha, Wis.-based Oxygen One. “It's been very smooth.”
This phase of PECOS has been years in the making. There have been numerous delays, most recently from May 1, 2013.
Those delays have been a big help in allowing providers to get doctors...
CMS reports PECOS-related glitch
January 16, 2014HME News Staff
NASHVILLE, Tenn. - A problem with ordering/referring physician data in the DME MAC claim system is affecting processing, as well as the data available in the myCGS web portal and the Jurisdiction C IVR, according to a bulletin from CGS. CMS and DME MAC system maintenance contractors are researching the issue. CGS says it will provide more information when it becomes available. CMS on Jan. 6 started denying claims with the names of physicians who are not enrolled in PECOS.
In brief: PECOS edits kick in, Harrison speaks out
January 3, 2014HME News Staff
BALTIMORE - The PECOS edits are scheduled to go into effect today. Noridian Administrative Services, the DME MAC for Jurisdiction D, reminded providers in a Jan. 2 bulletin that Medicare planned to implement Phase 2 denial edits on Jan. 6. With the edits in effect, contractors will verify that the ordering/referring physician or healthcare provider on the claim is in the Physician Enrollment, Chain and Ownership System (PECOS), and is eligible to order/refer in Medicare. Ordering/referring physicians...
In brief: CMS puts finger on fraud, DME MACs remind docs about PECOS
December 20, 2013HME News Staff
WASHINGTON - Industry watchers expect CMS to select a contractor early next year to administer a new fingerprinting provision aimed at curbing fraud and abuse. An RFP seeking a contactor to handle the process has a submission deadline of Dec. 23 and an award date of late February, according to AAHomecare. The provision mandates that “high-risk” providers submit fingerprints for a background check through the FBI's database. Those who will be subjected to the rule include newly enrolling...
DME MACs remind physicians of PECOS rules
December 20, 2013HME News Staff
BALTIMORE - Beginning Jan. 6, CMS will withhold payments to providers who provide DMEPOS prescribed by physicians not enrolled in the Provider Enrollment, Chain and Ownership System (PECOS), the four DME MACs reiterated in a letter to physicians this month. Physicians must enroll and register in PECOS, and have a specialty that makes them eligible to order DMEPOS for Medicare beneficiaries. “Help your DMEPOS supplier to continue providing quality service to your Medicare patients by promptly...
Take PECOS seriously, stakeholders say
November 8, 2013Liz Beaulieu, Editor
WASHINGTON - CMS has set a new start date for denying DME claims with the names of physicians who are not enrolled in PECOS and, this time, it may stick, industry stakeholders say.
Starting on Jan. 6, 2014, claims with the names of physicians who are not enrolled in PECOS will be denied, and the provider who submitted the claims will not be paid for the items or services that were furnished. Most recently, CMS had planned to start denying claims on May 1, 2013.
“It feels real this time,”...
CMS announces start date of PECOS edits
November 7, 2013HME News Staff
BALTIMORE - CMS will start editing DME claims to determine whether or not the ordering or referring physician has enrolled in the Provider Enrollment, Chain and Ownership System (PECOS) on Jan. 6, 2014, according to a new bulletin.Claims that don't pass muster will be denied, and the billing provider will not be paid for the items or services that were furnished based on the order or referral.CMS had planned to start editing claims on May 1, but it held off due to technical reasons. The agency has...
CMS announces improvements to PECOS system
July 25, 2013HME News Staff
WASHIINGTON - Various improvements, including validation checks, have been implemented for the Internet-based PECOS system, according to a CMS announcement. The checks for DMEPOS applications include minimum and maximum date ranges, and dollar amount values when entering surety bond information. This feature ensures the accuracy of the surety bond information entered, CMS stated. Providers and suppliers can also now use the system to manage the collection of required signatures for electronic documentation...
In brief: CMS delays PECOS edit, TSS employees sue
April 26, 2013HME News Staff
WASHINGTON - CMS is pushing back the start date for edits to the Provider Enrollment, Chain, and Ownership System (PECOS). In a bulletin, CMS cited “technical issues” for delaying the May 1 start date. The edits, once implemented, will deny claims that contain the names of physicians not enrolled in PECOS. CMS said it would advise on a new implementation date in the “near future.” In the meantime, informational edits will continue to be sent for those claims that would have...