Referring Physicians Must Enroll in PECOS to Secure Medicare Payments
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We have received a warning from Medicare that will result in future claim denials where you are the referring physician. If your physician is not enrolled there is a risk that Medicare will stop paying claims.
CMS, the Centers for Medicare and Medicaid, has implemented the following change request:
Change Request 6417-
Expansion of the Current Scope of Editing for Ordering/Referring Providers for Claims Processed by Medicare Carriers and Part B Medicare Administrative Contractors.
This new policy requires all referring physicians to be enrolled in PECOS (Provider Enrollment, Chain and Ownership System) Medicare’s provider enrollment system. You can be enrolled in Medicare and not be in the PECOS system. This would happen, if you have been enrolled for more than 6 years or have not updated your Medicare information.
You must be enrolled in PECOS before January 3rd, 2011.
In order to secure payment you need to contact Medicare Provider Enrollment at 1-888-608-8816, option 1 for Part B. They will be able to tell you if you need to fill out a new application and what form is required. You can also enroll online at
https://pecos.cms.hhs.gov.
We greatly appreciate your business and look forward to working with you and your patients in the future. If you have any questions please call, Nancy at 509-363-7745.