Medicare claims received on or after January 3, 2011, will not be paid if the ordering or referring provider is not enrolled in PECOS (Provider Enrollment, Chain and Ownership System).
Physicians should also be aware that PECOS enrollment is required to receive federal EHR incentives under the Medicare program. Beginning in 2011, Medicare providers who demonstrate "meaningful use" of an EHR stand to receive up to $44,000 in incentive payments over five years.
Palmetto GBA, California's Medicare carrier, recently identified 3,500 California providers (physicians and other practitioners who order services) who still do not have a record in PECOS. Over the next several weeks, these providers will receive letters from Palmetto notifying them of the need to enroll.
Physicians are urged to complete the application process as soon as possible. Applications are generally processed within 60 days, but can take longer if the application is incomplete or additional information is needed. Physicians who wish to take advantage of the incentive payments available for electronic prescribing, PQRI, and electronic health record program must be enrolled in PECOS.
CMA has also developed a step-by-step guide to walk physicians through the process, from determining if they are already in PECOS to helping them navigate the Internet-based PECOS enrollment system. This guide is available in the CMA Resource Library.
CMA also hosted a PECOS enrollment webinar with Palmetto. The previously recorded webinar is available for on-demand viewing in the CMA Reource Library.
Physicians who need help with the enrollment process can contact CMA's member service center, 800/786-4CMA (4262) or memberservice@cmanet.org, for assistance.
Contact: CMA's member service center, 800/786-4CMA or memberservice@cmanet.org.