Andrea's advice

Monday, March 21, 2011

BALTIMORE – So many home medical equipment providers are wrapped up in getting their ordering and referring physicians registered with PECOS that they haven’t focused on getting themselves registered, says consultant Andrea Stark.

While PECOS became available to providers only last year and there’s no deadline for them to register, new rules that go into effect this week make registering a good idea, she says.

“There hasn’t been a real driving need to do it, but there will be with the enhanced enrollment screening in place,” said Stark, a reimbursement consultant with MiraVista in Columbia, S.C.

On March 25, CMS began categorizing newly-enrolling and re-enrolling HME providers as “high risk” and “moderate risk” for fraud and began subjecting them to certain screening measures and site visits. (At some point, it also plans to subject the former to fingerprint-based criminal background checks.)

Being registered with PECOS allows providers to review and make changes to their applications online, reducing the chances of CMS finding any red flags during the screening process, Stark says.

“If you added enteral, but you didn’t disclose that, or if you told the NSC you do enteral but that box wasn’t checked off, technically you’re in violation of the supplier standards,” she said.

Providers should register with PECOS sooner rather than later, because it’s a multi-step process that takes time, Stark says.

“Some of our clients are saying, ‘I applied for it, but I haven’t heard anything,’” she said. “But registering with PECOS isn’t just about getting an ID and password. You have to verify who you say you are. You have to send in tax ID verifications. You have to follow the process to the letter or it will wither.”