Published 07/01/2010 - 1:00 p.m. CDT
On May 5, 2010, the
requirement that ALL Medicare
providers be enrolled in PECOS
was, apparently, moved up to
July 6, 2010.
TrailBlazer has
reported that they have not
received official notification
this earlier date of
enforcement and will continue
with original plans of a
January 3, 2011,
deadline.
Says
TrailBlazer: for "claims
received on
or after
[January 3, 2011]...requiring
a referring/ordering provider,
claims
processing editing
will verify the
ordering/referring provider
submitted
on the claim is of
the specialty eligible to
order/refer and is either
enrolled in PECOS or the
contractor's master provider
file. If either of
those
requirements is not met, the
billing
provider will
not receive
payment for
the ordered/referred
services/items
billed."
Enroll at the PECOS web
site
HERE
"In June
Letters were recently sent to
physicians and
non-physician practitioners
who are currently enrolled in
Medicare but who do not
have an established
enrollment record in the
Provider Enrollment, Chain
and Ownership System (PECOS).
Recipients of
the letter
include physicians and
practitioners who not only
bill for
Medicare services,
but who also order and refer
services for Medicare
patients."
Trailblazers says that "to
encourage the recipient to
submit an enrollment
application as
soon as
possible for the following
three reasons:
Ensure
correct Medicare payment for
services provided to
beneficiaries.
To
continue ordering and
referring services for
Medicare
beneficiaries*.
To be eligible to receive
incentive payments for
meaningful
use of certified
electronic health
technology."There are two
ways to enroll in
PECOS:
Electronically
through Internet-Based PECOS.
For information on
how to
access Internet-Based PECOS,
please refer to the
information on
the
Internet-Based
PECOS page.
Mail a
paper
CMS-855I
application.
Note: Applications
received via Internet-Based
PECOS are
given higher
priority handling and have
shorter processing times than
paper applications. Refer
to the notice
TrailBlazer
Average Processing Days for
CMS-855
Applications.