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CMS again updates PECOS system for easier use

September 22, 2012

The U.S. Centers for Medicare & Medicaid Services (CMS) said new technical upgrades will make the Internet-based Medicare Provider Enrollment, Chain, and Ownership System (PECOS) easier for health care practitioners to use.

  • Health care practitioners and product suppliers can now submit their entire enrollment application, including supporting documentation, electronically with a new digital document feature. They are no longer required to physically mail copies of their supporting documentation to Medicare Administrative Contractors (MACs). Instructions for the new system are provided in the “Digital Documents Repository How to Guide” on at www.cms.gov.
  • Individual practitioners who reassign benefits to individuals or organizations with multiple practice locations will be able to designate a primary and secondary practice location where services are rendered. Selecting a primary and secondary practice location does not restrict the practitioner from providing services at other practice locations associated with the individual or organization to which they are reassigning benefits. It is recommended that a primary and secondary practice location be specified, but it is not required.
  • Practitioners and suppliers will now be able to enter multiple contact persons in the “Contact Information” section and will have the ability to identify the contact’s relationship to the provider or supplier. While Internet-based PECOS requires at least one contact person to be entered in this section, additional contacts and the relationship to the provider field are optional.
  • At least one managing employee will now be required when submitting a CMS 855A, CMS 855B and CMS 855S enrollment application. Applications that do not include at least one managing employee will receive an error message in Internet-based PECOS under the “Error/ Warning Check” tab and will not be able to proceed with submitting the enrollment application. Internet-based PECOS will also recommend that at least one owner is entered for a CMS 855A, CMS 855B and CMS 855S application. Applications that do not include at least one owner will receive a warning message under the “Error/ Warning Check” tab in PECOS. This warning message will not prevent the user from submitting the enrollment application.
  • Practitioners and suppliers will now have the option to select “County” in the “Geographic Location” topic when identifying the Geographic Location where services are rendered for CMS 855A and CMS 855B enrollment applications. Prior to this feature, the only available options were state, city, or ZIP code. When selected, PECOS will populate the county field with all counties that exist within the enrollment state identified for the application.
  • The CMS 8550 paper application, used to enroll in Medicare solely to order and refer services, has been redesigned and those changes are reflected in PECOS. (Providers who are currently enrolled in Medicare and are of a specialty that is eligible to order and refer already have the ability to order and refer services and therefore are not required to submit a separate CMS 8550 enrollment application solely to order and refer services, the CMS notes.)

The new Medicare Learning Network Matters (MLN) article “Addition of Digital Document Repository to Provider Enrollment Chain and Ownership System (PECOS)” (MLN Article SE1230) offers an introduction to the new digital upload features that allow practitioners to submit supporting documents and submit them electronically with their enrollment application.

It can be downloaded on the MLN Web page (www.cms.gov/MLNMattersArticles).

The CMS has been soliciting practitioner input on improvement of the PECOS system over the past year. An initial round of improvements was made in February. (See the March edition of AOA News. PECOS can be accessed at https://pecos.cms.hhs.gov/.

CMS offers Medicare Physician Fee Schedule Search Tool

The CMS website now offers a redesigned, searchable look-up tool that provides Medicare Physician Fee Schedule (MPFS) payment information for physician and non-physician practitioner services.

The easy-to-use MPFS Search Tool allows practitioners to:

  • Search payment amounts, relative value units (RVUs), various payment policy indicators (i.e.: covered, bundled, multiple procedure payment reduction percentage, payment of assistant-at-surgery, diagnostic procedure supervision, etc.), and geographic practice cost indexes (GPCIs) for a single procedure code, a range of procedure codes, or a list of procedure codes.
  • Find the national payment amount, the payment amount for a specific Carrier/Medicare Administrative Contractor (MAC), or the payment amount in a specific locality.

Updated at least quarterly, the look-up tool currently provides information on more than 10,000 physician and non-physician practitioner services.

Instructions on use of the MPFS Search Tool can be found in the Medicare Learning Network booklet, “How to Use the Searchable Medicare Physician Fee Schedule” (http://tinyurl.com/d8flzp5).

The Medicare Physician Fee Schedule Search Tool can be accessed at www.cms.gov/apps/physician-fee-schedule/.

Resources help prevent ID theft

A new package of Medicare Learning Network® (MLN) products is designed to help Medicaid providers prevent medical identify theft; however, it could be helpful to Medicare practitioners as well, according to the CMS.

Developed as part of the agency’s Medicaid Program Integrity efforts, it includes:

  • “Safeguarding Your Medical Identity” — This Web-based training course (WBT) is designed to provide education on medical identity theft. It includes information on how to recognize risks and resources that Medicare and Medicaid providers can use to protect their medical identity.

The course can be accessed in the Web-Based Training Courses section on the MLN Products Web page (http://tinyurl.com/MLNProducts).

  • “Medicaid Program Integrity: Understanding Provider Medical Identity Theft” — This booklet is designed to provide education on the scope and definition of medical identity theft.

It includes information on cases involving stolen provider medical identities and strategies that Medicare and Medicaid providers can use to protect themselves against medical identity theft.

The booklet can be accessed at http://tinyurl.com/cr36hx8.

  • “Medicaid Program Integrity: Preventing Provider Medical Identity Theft” — This fact sheet is designed to provide education on how to prevent provider medical identity theft.

It includes information on actions Medicare and Medicaid providers can take to mitigate potential risks to their medical identity.

The fact sheet can be accessed at http://tinyurl.com/ca5k6os.

  • “Medicaid Program Integrity: Safeguarding Your Medical Identity Using Continuing Medical Education (CME)” — This educational tool is designed to provide a list of websites and other resources related to Medicare and Medicaid medical identity theft.

The list can be accessed at http://tinyurl.com/cmk6rxz.

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