What does the acronym PECOS mean?
The Provider Enrollment, Chain and Ownership System
What is it?
PECOS is a new way for physicians and other health care practitioners to modify their provider file online. Physicians must enroll with the system to use it.
PECOS was designed so that the referring physician’s credentials can be verified before Medicare claims are paid.
What does it cost?
I’m already enrolled in Medicare, do I need to enroll with PECOS also?
YES! You must enroll with PECOS before July 6, 2010. If you have enrolled with the program since 2003 you may already be in the system. HOWEVER, it is very important to your patients that you verify your PECOS status. Otherwise they may not receive the items you prescribe.
Why haven’t I heard of it before?
Medicare has encouraged physicians to update their provider files since 2006. However, it has never impacted the payment of claims for referred items or services. Beginning in October of 2009 the first phase of the system was implemented.
Under the first phase claims are being paid but with a warning that the provider is not in the PECOS system.
The second phase begins on July 6, 2010. At that time claims for items referred by physicians who are not in the system will deny.
What other professional must register with PECOS?
Non-physician practitioners who are eligible and those are:
- Physician Assistants
- Certified Clinical Nurse Specialists
- Nurse Practitioners
- Clinical Psychologists
- Certified Nurse Midwives
- Clinical Social Workers
Where can I get technical support?
I have an NPI number, am I in PECOS?
Probably not. Your National Provider Identification (NPI) is not registered with the PECOS system until you complete the registration process.
What happens if I do not register?
Beginning January 4, 2010 any claims for items or services that you have prescribed will be denied if you are not in the PECOS system. This applies to Medicare claims only. Not being in the PECOS system will make it difficult for your patients to receive the items they need and will prevent / delay hospital discharges.
Also, you may have previously prescribed items that are being rented. These items can go back three years or more (oxygen for example). These claims will also deny if you are not registered with PECOS.
Is www.getpecos.com a Medicare website?
NO! We are DME providers who will be severely impacted once the PECOS system is fully implemented in January, 2010. Our goal through this site is to educate physicians and non-physician practitioners about the program and encourage their prompt registration.