[mdflores]

This has probably been discussed too many times, but can someone tell us if there is a way for us to check the PECOS database to see if the phsycians are enrolled? We have a few who tell us they enrolled, but we are still getting the warnings on their claims.
Thanks, Michael

[DeeDee]

A Message of Interest to Physicians and Nonphysician Practitioners Regarding NPI and Enrollment Files

As stated in the Centers for Medicare & Medicaid Services (CMS) provider Listserv messages that were sent last fall concerning CRs 6417 and 6421, CMS has made available a file that contains the National Provider Identifier (NPI) and the name (last name, first name) of all physicians and nonphysician practitioners who are of a type/specialty that is eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS that contain an NPI). This file is downloadable from the Medicare provider/supplier enrollment Web site www.cms.hhs.gov/MedicareProviderSupEnroll, click on “Ordering/Referring File” on the left-hand side.

This .pdf file contains approximately 800,000 records. Due to the large size of this .pdf file CEDI suggests you right click and select “Save as” before attempting to open this file.

A new file will be made available periodically that will replace the posted file; at any given time, only one file (the most recent) will be available. The file can be viewed online. In addition, it can be downloaded by users with technical expertise and further sorted or manipulated. It can also be used to search for a particular physician or nonphysician practitioner by NPI or by name. Please note the following: (1) Records are in alphabetical order based on the surname of the physician or nonphysician practitioner. (2) Name suffixes (e.g., Jr.), if they exist, are not displayed. (3) There are no “duplicates” in the file. Many physicians or nonphysician practitioners share the same first and last name; their corresponding NPIs are the assurance of uniqueness. (4) Deceased physicians and nonphysician practitioners are not included in the file. (5) If a user is unsure of a physician or nonphysician practitioner’s NPI, he or she can look it up in the NPI Registry at https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do.

Keep in mind that the record in the NPI Registry is not the Medicare PECOS enrollment record.

Thank you,
National Government Services, Inc.
Corporate Communications

Also, if you use Fastrack as your software they have a program available for download that will verify your physician list against the current PDF of approx. 14,000 pages on the CMS website and then provide you with an Excel spreadsheet of your physicians who were not listed in the document.

[JoeyGraham]

VGM now has a tool that lets you look up PECOS records without having to sort through that giant pdf file. See this article:

VGM USER-FRIENDLY PECOS DATABASE now operational!

As many HME providers are aware, CMS had recently posted a file that contains the national provider identifier (NPI) numbers and names of physician and non-physician practitioners (NPPs) with current enrollment records who are eligible to order and refer Medicare beneficiaries. Providers now have a way to compare their referral sources against the “PECOS” database.
Unfortunately, the file contains about 800,000 records (16.63MB in size, 13,653 pages) and is in a rather tedious .pdf format. Download times may be lengthy. Practice mailing and physical addresses are not included, nor are the provider taxonomy information, licensure and other data found within the National Plan & Provider and Enumeration System (NPPES).

To ease the search burden, VGM’s Jackie Woodman and Mark Higley converted the files into a more user-friendly “SQL” database file. These tools allow users to quickly access and search and sort the data. As many physician and NPP names are same or similar, users may copy and paste the NPI number from their search into a convenient NPPES window on the same page ensure the information is correct and applicable to the provider.

VGM will update the database in conjunction with CMS releases.

Instructions and link to utilize the PECOS Database Lookup Tool are here:

The VGM Group

[SheilaS]

We are using the VGM search link, makes the tracking alot easier.

[PFSCIO]

Try our PECOS Validation Tool at Physicians Filing Service, Inc. - PFS.

We converted the file into a SQL database and cross reference it to the NPI database.

We also notify the user if the name in the PECOS file does not match the name in the NPI database!

[Brian]

Our HME software automatically checks the physician's NPI against the PECOS database. Physicians who are good to go display in green as "PECOS Enrolled" when added to an order. No need to manually check or ever leave our software. Users may still reference and search the PECOS database in our standard smart lookup format.

[Cha]

Brian, what's the name of your software? i'm currently looking for new dme electronic billing software...any recommendations?

[Brazzell Marketing]

Originally Posted by PFSCIO

Try our PECOS Validation Tool at Physicians Filing Service, Inc. - PFS.

We converted the file into a SQL database and cross reference it to the NPI database.

We also notify the user if the name in the PECOS file does not match the name in the NPI database!

Can you provide a link to the exact page? I checked about six pages and gave up. I want to link to the service from this page of my Online Home Care Sales & Marketing Magazine here: New Medicare Rule Could Cut Your Business by 40% | BMA ADVisor