[Margie]

ARE DME PROVIDERS supposed to ENROLL in PECOS? Hospitals?
Isn't it just for ordering and referring physicians?

THANKS

[DMEisgoodfun]

DME's can now enroll in PECOS. We had changes to our application last fall
and were able to reenroll thru PECOS.

[Margie]

If you're a provider with medicare, is it a REQUIREMENT to be enrolled in PECOS? Will claims deny in the future when they start denying for ordering/referring providers who are NOT enrolled?

Thanks

[wpbiller]

Originally Posted by Margie

If you're a provider with medicare, is it a REQUIREMENT to be enrolled in PECOS? Will claims deny in the future when they start denying for ordering/referring providers who are NOT enrolled?

Thanks

In reference to this comment, I am a billing clerk at a DME, are we actually required to enroll in PECOS?

[AndreaStark]

Physicians are required to be listed in PECOS to pass claim edits (the start of rejections has been postponed for the time being). If the ordering physician's NPI is not found in the PECOS database once edits are enforced, the claim will reject. Note: Physicians will need to enroll with thier individial NPI first, not their group NPI.

The reason some physicains may not currently be listed in PECOS is because they probably enrolled in Medicare prior to the development of the PECOS system and have not made any changes or updated their information in the past 6 years or so. Those physicians will need to either enroll in the system electronically or submit a new paper enrollment form to update their information and become registered in PECOS.

Electronic enrollment in PECOS does NOT take the place of submitting a paper enrollment applications (i.e. CMS-855S). While electronic enrollment is considered faster and easier to track, physicians and suppliers may still opt to submit paper enrollment forms instead.

Just last year, CMS completed a massive upload of all active DME supplier information into PECOS. So if you currently have an active Medicare billing number, you are likely already in the system.

I reccomend you take moment to log into PECOS and check to see that your are appropriately listed to provide any products that require accreditation. Along with editing claims for the ordering physician, CMS will also be using the system to edit claims based on product accreditation. So it's important to make sure you are listed as accredited to provide certain products.

It is quite a process for suppliers to initally access their information in PECOS. Your AO must be the first one to register and will need to provide detailed information about your company. Only after being validated by the NSC will they have access to your company information. This process could take a couple of days or a couple of weeks. I reccomend you go ahead and start enrollment when there is no immediate need. If you need to make an immediate update but are not yet approved to log into PECOS, you may still use the paper enrollment form.

Hope this helps clear up any confusion. MiraVista has been following PECOS since it was first introduced. Multiple articles on the topic with detailed information are availabie on our news blog at: www.miravistallc.com/blog. In the search field, enter PECOS.

*Michelle, MiraVista LLC

[Amy Holmes]

I highly recommend you start the process of enrollment in PECOS. We went
without payment for a month because something "happened" to our NPI at CEDI
and the only way to fix the problem was to get enrolled in PECOS. I argued
that we are DME Providers and it was not required but they kept telling me
the only way to fix it was to enroll. Once enrolled our CEDI submission were
no longer rejected.

I have still not read where it is a requirement but it's better to be safe
then sorry. Hope this helps.

Amy Footit
Billing Supervisor
Lakes Area Health Mart
Dura Med, Inc.


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