Physician and Practice PECOS Enrollment

Every physician regardless if they are affiliated with a practice or not will need to individually enroll in the PECOS Program; any physicians that enrolled in PECOS after 2003, may be in the program, however it is highly recommended that all verify their status of the PECO enrollment. Physicians and other Healthcare Providers/Suppliers can verify their individual status by clicking here.

Medicare Program Enrollment

If a Physician or other Healthcare Provider/Supplier is already registered with Medicare they are still required to register with PECOS. PECOS registration has been mandated since 2010, all claims referred by a Physicians or other Healthcare Providers/Suppliers will be denied if the referrer is not registered within the PECOS Program.

The following steps will be required to use the PECOS Program and enroll in the Medicare Program:

Appointing an Authorized Official.

There are a number of requirements associated with enrollment, first and foremost each Provider and Supplier must appoint an Authorized Official (AO), the AO is the individual(s) in an organization that is responsible for using PECO S. The AO must register and be authenticated by Medicare before a Provider or Supplier is enrolled in the Medicare Program. To register and authenticate an AO for your organization, follow the steps to Register for a User Account outlined here.

Once the application for an AO is approved, additional individuals in the Provider and Supplier organization can now apply for an account to act on behalf of that Provider and Supplier, register here: "Register for a User Account" , the AO of the Provider and Supplier will approve the application through the CMS system.

Initiate Enrollment in PECOS

Before a Provider and Supplier initiates the enrollment process, the following information will be required to successfully complete the enrollment process:

Enrollment Information Needed:

• Legal Name of Business
• TIN (Taxpayer Identification Number) of Provider or Supplier Organization
• NPI (National Provider Identifier Number) of Provider or Supplier Organization
• Current Practice Location Address
• Appropriate information regarding:
  • Any Medicare billing infractions, suspension or revocation of a license to provide Health Care
  • Information if ever convicted of a Federal or State felony offense.
  • Exclusion or Debarment from participation in a Federal or State health care program
• Bank Account Information, Electronic Funds Transfer Authorization Agreement

¹ OANDP http://www.oandp.com/pecos/
² PECOS: https://PECOS.cms.hhs.gov/PECOS/login.do
^{3 PECOS: https://PECOS.cms.hhs.gov/PECOS/login.do}

To initiate enrollment, the now registered PECOS user can begin the application process by logging in here with their individual user id and password. The user will begin the enrollment process by answering a series of questions to process the enrollment. Once the questions are answered, the information is confirmed by the user that all the required data has been entered. The system will allow the user to save the enrollment application to submit at a later date or to process it. If choosing to process the enrollment application, print and save the document for internal records. When the selection to process enrollments is chosen, the system will display a list of supporting documents that must be submitted externally to a Medicare enrollment advisor. The system will prompt the user for an electronic signature and electronically submit the enrollment application. A confirmation email will be sent to the user indicating the application was successfully transmitted to the users Medicare enrollment advisor. Once the enrollment application is submitted, changes cannot be made.

Status of Enrollment Application

The PECOS Program allows for applicants to periodically check the status of their application, by accessing the home page a user can choose the Application Status link , the status information will then be displayed for the user.

PECOS Application Fee

Providers and Suppliers are required to pay an application fee to enroll in the Medicare Program. Medicare enrollment advisors will not process applications without payment of the appropriate application fee. Applicants may request a hardship exception by submitting a written request and submitting supporting documentation that describes the hardship and why the hardship is justified. Contact the appointed Medicare enrollment advisor to request a hardship exception.

IMPORTANT RESOURCES

How to Register with PECOS, register here: https://PECOS.cms.hhs.gov

NEED MORE PECOS Information?

Contact your DRIVE MEDICAL Industry Expert HERE

⁴ PECOS: https://PECOS.cms.hhs.gov/PECOS/login.do
⁵ PECOS: https://PECOS.cms.hhs.gov/PECOS/sscHome.do
⁶ PECOS: http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/Downloads/ApplicationFeeRequirementMatrix.pdf

Understanding PECOS
Acronym

PECOS is acronym for the "Provider Enrollment, Chain and Ownership System" for Provider and Suppler Organizations. This system is internet based and allows for Physicians or other Healthcare Providers/Suppliers to manage their provider files at Medicare. All Physicians and additional Healthcare Providers/Suppliers are required to register with the PECOS Program, failure to register with PECOS will result in claim denials for the items that are prescribed. Claims will not be reimbursed via Medicare unless the provider is enrolled in PECOS.

PECOS Enrollment

Enrollment is required for: