What is the latest information regarding PECOS and homecare agencies?
CMS issued Transmittal 778 on Sept. 28, 2010 regarding expansion of claims edition to meet the July 6, 2010 PECOS requirement. According to the transmittal, the initial phase begins Oct. 1, 2010, and the second phase is set to begin on or after July 1, 2011. These edits are being put into place to begin verification of physician's name and NPI number as they appear on the "Medicare Ordering Referring File." Agencies that bill the Medicare program must ensure that claims contain accurate information from the "Medicare Ordering Referring File."
Click here for Transmittal 778.
Will I receive payment during Phase 1 (Oct. 1, 2010 to June 30, 2011) if the attending physician is not on the PECOS file?
Phase 1 begins Oct. 1, 2010 and ends on June 30, 2011. Agencies will receive payment even if the attending physician NPI is not on the national PECOS file. Agencies will receive a message on the remittance advise stating that claims may not be paid in the future if the attending physician is not enrolled in Medicare or if the attending physician is not of the specicialty eligible to be an attending physician for HHA services.
Will I receive payment during Phase 2 (On or after July 1, 2011) if the attending physician is not on the PECOS file?
If the billed service requires an attending physician and the attending physician's NPI is not on the claim, the claim will not be paid. If the attending physician's NPI is on the claim, Medicare will also verify that the attending physician is on the national PECOS file. If the attending physician is on the PECOS file, but not as a specialty eligible to be an attending physician, the claim, during Phase 2, will not be paid.
What is the PPS Plus PECOS Enrollment Validator?
The PPS Plus PECOS Enrollment Validator allows homecare providers to determine the status of their physicians regarding PECOS registration. The PECOS report will show:
- Physicians who have submitted an application (but are not yet approved)
- Physicians with no record of an application
Why do I need the PPS Plus PECOS Enrollment Validator?
Homecare agencies need to verify that their attending physicians are registered in PECOS. If an attending physician is not enrolled, claims will be denied beginning in July of 2011.
How much does the PPS Plus PECOS Enrollment Validator cost?
It's FREE! PPS Plus Software wants to provide our expertise for the benefit of the industry, so this product is free of charge for all homecare agencies. This product is also one of the features in our OASIS analysis software, Home Health Edition.
How do I obtain the PPS Plus PECOS Enrollment Validator?
Click on the "Get Our Free Validator" button at the top of this page. After filling out the request form, you will be supplied with a link to download the installation application.
How do I use the PPS Plus PECOS Enrollment Validator?
Download a copy of the PPS Plus PECOS Enrollment Validator Installation Guide & User Manual which will give you step-by-step instructions on using the product.
What do I need to use the PPS Plus PECOS Enrollment Validator?
The validator works on Windows XP, Vista, 7 systems. It does not work on Mac and Linux. All Service Packs and security patches must be installed.
How does the PPS Plus PECOS Enrollment Validator access my physician data?
The validator verifies the physician information by importing your OASIS data. The NPI number is contained on the OASIS.
How current is the PPS Plus PECOS Enrollment Validator?
The validator checks daily for updates from CMS. Users will receive the latest information based on updates from CMS. Users will receive the latest information based on the updates from CMS.
What support options are available?
We offer support via e-mail (.(JavaScript must be enabled to view this email address)). We aim to answer any query within one working day
Get In Touch
Call us at 888-897-9136 about support, assistance, service issues or any other questions. Or...
Contact Us OnlineWhat Others Have Said
PPS Plus Software's PECOS Enrollment Validator allows my agency to quickly and easily identify physicians who have or have not enrolled the Medicare Provider Enrollment, Chain and Ownership System. This tool saves my agency time by giving us an automated way to obtain this information, allowing us to focus on our most important objective -- patient care.
Penny Lovitt, VP of Professional Services
Deaconess Home Health Care
Hattiesburg, MS
Tech Specs
Compatible Operating Systems
Windows® Server 2003, Windows® Server 2008, Windows® XP, Windows® Vista, Windows® 7
Processor
400 MHz Pentium processor or equivalent minimum
1 GHz Pentium processor or equivalent recommended