PECOS: Will your Medicare claims be rejected? July 18, 2011 Medicare, News, Public Health Medicare, PECOS 2 Medicare physicians who have not updated their enrollment information in the past five years may need to fill out another application or risk not being paid for ordered or referred services. New rules authorize Medicare to reject claims if an ordering or referring physician is not identified in Medicare’s Provider-Supplier Enrollment, Chain and Ownership (PECOS) enrollment system. It is not too late to enroll in PECOS and avoid possible denials. The Centers for Medicare & Medicare Services (CMS) had previously announced that, beginning January 3, 2011, it would automatically deny claims for services ordered by physicians not yet enrolled in PECOS. However, due to enrollment backlogs and other systems issues, CMS decided to delay the start of these automatic claims edits. CMS is working diligently to resolve the backlogs and other issues and has said that it will provide advanced notice to the provider and beneficiary communities before contractors begin any automatic nonpayment actions. The CMA has developed two resources to assist physicians with Medicare enrollment: · Medicare Enrollment Guide for Individual Physicians is a step-by-step guide that walks physicians through the enrollment process, from determining if they are already in PECOS to accessing the Internet-based PECOS enrollment system. · PECOS enrollment webinar is a members-only webinar hosted by CMA and Palmetto. Comments are closed.
