Understanding PECOS
The Provider Enrollment, Chain and Ownership System (PECOS) database is for physicians who have registered with the Centers for Medicare & Medicaid Services (CMS). PECOS supports the Medicare provider and supplier enrollment process by allowing registered users to securely and electronically submit and manage Medicare enrollment information. While Medicare’s PECOS website has been around for several years, the rollout of new features and capabilities has been slow. Now that the Medicare enrollment capability is up and running, the move from paper to electronic enrollment is possible, and the benefits are impressive.
The Benefits
From a revenue and time perspective, the benefits associated with PECOS are plenty. In addition to eliminating costs associated with paper and postage, the move away from “snail mail” to online processing significantly speeds the enrollment process, which in turn improves cash flow. If anything is missing from an application, if additional documentation is needed, and/or when the application is complete, Medicare will reach out to the submitter via email. With PECOS, there is no more waiting for “snail” mail.
PECOS offers a real-time view of provider enrollment status. Without PECOS, this information could only be retrieved by calling Medicare and speaking with them directly. If the person inquiring about a provider’s enrollment status is not listed on the provider’s profile, Medicare will not give any status on the pending enrollment. With access to PECOS, anyone listed as a contact on the provider’s individual record can easily pull enrollment status details.
For organizations who partner with an outsourced provider enrollment company, the burden of completing Medicare enrollments can be alleviated when allowing the enrollment partner to act on the provider’s behalf through Surrogacy Access, which allows designated staff at the enrollment partner company to log into a provider’s portal to complete and manage the provider’s Medicare enrollment. For larger organizations with hundreds of providers, outsourcing Medicare enrollment to a partner is a tremendous time and financial saver. With access to PECOS, the partner company can efficiently manage the entire initial and re-validation process.
Clarifying Confusion
One common PECOS misconception is the belief that an online PECOS application also requires a duplicate hard copy mailed to Medicare. This is not true. Once submitted online, there are no additional steps required as long as the online application is complete and accurate. If Medicare has a question or request, the submitter will be alerted via email.
Another point of confusion is the timeframe which the authorized signature needs to be electronically signed off on for reassignment. Previously it was three days; now with the extension, organizations have 14 days to submit authorized signatures.
When working with a provider enrollment company, privacy concerns over sharing a provider’s user name and password have some organizations opting out of PECOS. For those who want tighter control, PECOS offers the option of logging in and authorizing someone to work on the provider’s behalf. The authorized person then creates his/her own user name and password.
Bottom line: Provider enrollment professionals know what they are doing and will work to make sure the provider gets paid appropriately. Enabling them to access PECOS will allow them to do their job more efficiently and to get your provider’s billing faster than if processed via paper.