CMS on PECOS: Docs as ready as they'll ever be

Friday, March 22, 2013

WASHINGTON – After two years of outreach, CMS officials say they expect most claims to pass upcoming edits in the Provider Enrollment, Chain, and Ownership System (PECOS).

CMS announced on March 1 that claims that contain the names of physicians not enrolled in PECOS will be denied starting May 1.

“We actually have been monitoring the number of informational messages that do go out, and it’s about 1% or less across the different provider types,” said Zabeen Chong, director of the Provider Enrollment Operations Group at CMS, during a call March 20.

Other takeaways from the call:

• Approvals for physicians just starting the enrollment process should take 45 to 60 days.

• Providers who receive denials as a result of the edits can appeal them like any other denied claims.

• CMS updates a list of enrolled physicians on its website on Mondays and Thursdays.

Some callers during the question-and-answer period expressed concern that physicians won’t be ready by May 1.

“This is an industry that waits, by and large, for a deadline to comply,” said one caller.

CMS officials held firm.

“We’ve been doing education and putting out materials on this for two years,” an official said. “At some point, we do need to implement the final rule.”