August/September 2010 Newsletter
Clarification on PECOS Enrollment Deadline
The deadline for ordering and referring providers to enroll in PECOS (Provider Enrollment, Chain and Ownership System) has been softened. The deadline date in the interim final rule from CMS (Centers for Medicare & Medicaid Services) is July 6, 2010; however, CMS will not enforce it until January 3, 2011.
PECOS is used to electronically enroll physicians in the Medicare program, but numerous physicians have complained about problems with the system, leading CMS to issue the delay. CMS is reviewing the process and continuing to update the system to make enrollment easier. At this time, CMS will not automatically reject claims if the physician is not properly enrolled in PECOS. Although claims with enrollment discrepancies will not be automatically rejected, they will come back with informational messages that note that PECOS issues need to be resolved. Payments will not be made for claims received on or after January 3, 2011 if the ordering/referring physician is not enrolled in PECOS.