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  • Page 1 of 17

    PECOS FAQs

    ICN 909015 December 2017

    PRINT-FRIENDLY VERSION

    Target Audience: Medicare Fee-For-Service Program (also known as Original Medicare)

    The Hyperlink Table, at the end of this document, provides the complete URL for each hyperlink.

    https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Internet-Based-PECOS-FAQs-Fact-Sheet-ICN909015TextOnly.pdfhttps://www.cms.govhttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNGenInfo

  • MLN BookletPECOS FAQs

    ICN 909015 December 2017Page 2 of 17

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    TABLE OF CONTENTSGetting Started with PECOS 4

    What account login information do I need before accessing PECOS? 4Who can work in PECOS? 5What information do I need before I begin my enrollment via PECOS? 5What is the difference between an enrollment application and an enrollment record? 6I have been enrolled in Medicare for many years, but when I access PECOS to view the enrollment record, it doesnt show the information. Is this an error? 6What enrollment changes cannot be done through PECOS? 6Are any provider or supplier types restricted from using PECOS? 7When is PECOS available? 7

    Enrollment Applications 7

    Am I required to complete and submit enrollment applications via PECOS? 7How will I know if I successfully submitted my enrollment application using PECOS? 7How do I know when I need to create a new enrollment or just update an existing enrollment? 8I am an oral surgeon (dentist). How do I enroll in Medicare? 8

    Application Fee and Supporting Documentation 8

    Am I required to pay an application fee? 8What is the hardship exception to the application fee? 8What happens if I do not submit the fee or hardship exception request? 9Do I need to submit additional information outside of PECOS to complete the application? 9Do I need to confirm my account information using bank letterhead or a voided check if I electronically submit and sign the Electronic Funds Transfer (EFT) Agreement (Form CMS-588)? 9What are the penalties for falsifying information when using PECOS? 9

  • MLN BookletPECOS FAQs

    ICN 909015 December 2017Page 3 of 17

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    Enrollment Application Issues 10

    I am a physician or non-physician practitioner (NPP). What should I do if PECOS doesnt find my SSN? 10I am a physician or NPP. What should I do if I dont have an SSN or dont want to use my SSN in a web transaction? 10I see an Invalid Address error. How do I resolve this? 10What is the Special Payments address? 10Will I be timed out when using PECOS? 10

    Submitting Reportable Events 11

    My information changed. Am I required to update my Medicare enrollment information? 11What is a reportable event? 11How do I change the provider enrollment information? 11I am a DMEPOS supplier, and I have a new business location. Can I add this location to an existing PECOS enrollment? 11

    Revalidations 12

    What is revalidation? 12My MAC requested that I revalidate my enrollment information. What does this mean? Can I complete the action using PECOS? 12When must I revalidate? 12Will I still receive a revalidation notification from my MAC? 12Should I submit my revalidation if I havent received a notice from my MAC? 13Can I revalidate without completing the entire enrollment application again? 13What will happen if I dont submit my revalidation by the due date? 13If the information in my revalidation is different than what CMS has on file about my practice location, authorized representatives, or other pertinent information, will there be any penalty for not reporting the change within the required time frames? 13

    Resources 14

  • MLN BookletPECOS FAQs

    ICN 909015 December 2017Page 4 of 17

    This booklet addresses frequently asked questions (FAQs) about the Provider Enrollment, Chain, and Ownership System (PECOS). PECOS is an online Medicare enrollment system where providers and suppliers can:

    Submit Medicare enrollment applications

    View and print enrollment information

    Update enrollment information

    Complete the enrollment revalidation process

    Withdraw from the Medicare Program voluntarily

    Track the status of a submitted Medicare enrollment application

    Find more information about the Medicare enrollment process on the Medicare Provider-Supplier Enrollment webpage. For additional resources and useful links, see Table 1 at the end of this booklet.

    PROTECT YOURSELF AND CMS PROGRAMS FROM FRAUD

    Your National Provider Identifier (NPI) and Tax ID are publicly available information. Use extra caution to monitor and protect your professional and personal information to help prevent fraud and abuse. You must also ensure your patients personal health information is secure. The Centers for Medicare & Medicaid Services (CMS) provides the following resources to help:

    Medicare Fraud & Abuse: Prevention, Detection, and Reporting Office of Inspector General Help Fight Medicare Fraud for patients

    GETTING STARTED WITH PECOS

    What account login information do I need before accessing PECOS?CMS uses several systems necessary for provider enrollment. Specifically, the Identity & Access Management (I&A) System allows you to:

    Apply for and manage NPIs in the National Plan and Provider Enumeration System (NPPES) Use PECOS to enroll in Medicare or update or revalidate your current enrollment information Register to receive Electronic Health Record (EHR) incentive payments for eligible professionals

    and hospitals that adopt, implement and upgrade, or demonstrate meaningful use with certified EHR technology

    Before enrolling via PECOS, you must have an I&A System account. Organizational providers and suppliers must designate an Authorized Official (AO) to work on their behalf in these systems.

    https://pecos.cms.hhs.govhttps://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/CMS1243333.htmlhttps://oig.hhs.govhttps://www.medicare.gov/forms-help-and-resources/report-fraud-and-abuse/fraud-and-abuse.htmlhttps://nppes.cms.hhs.gov/IAWebhttps://nppes.cms.hhs.gov/IAWebhttps://nppes.cms.hhs.govhttps://pecos.cms.hhs.govhttps://ehrincentives.cms.govhttps://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnrollhttps://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll

  • MLN BookletPECOS FAQs

    ICN 909015 December 2017Page 5 of 17

    Who can work in PECOS?Organizational providers and suppliers must designate an AO to work on their behalf in the CMS systems necessary for provider enrollment. These systems include the I&A System, NPPES, and P

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