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Don’t Lose Out on the EHR Incentive Dollars: Enrollment in PECOS Required

SEPTEMBER 2010

As published in the West Tennessee Medical News and Memphis Medical News.

The Medicare Electronic Health Record (EHR) Incentive Program is only available to "eligible" professionals and hospitals. The final rule will soon be published and CMS is planning to use the Provider Enrollment, Chain and Ownership System (PECOS) to verify Medicare enrollment. While this may seem like a no-brainer, you may or may not have an enrollment record in PECOS. Use the checklist below to avoid a last minute scramble that could impact your incentive payment.

You may NOT be in the "system" if:

• You are a physician and have not updated your enrollment information since November 2003. (No further action is required if you have updated your Medicare enrollment information since that date).
• You are a physician who reassigns Medicare benefits to a group or clinic and they are not enrolled (or updated their information since November 2003). You must enroll as well as your group or clinic. (If your group or clinic has not enrolled, you will need to submit a paper enrollment application (CMS-855).
• If they have enrolled but you have not, you can use the Internet to enroll.)  You have submitted an enrollment application less than 90 days ago and you haven't heard if you have been accepted.

If you are unsure you can verify your enrollment in three ways:

• Check http://www.cms.gov/MedicareProviderSupEnroll for the "ordering report." If you are on that report, you are currently in the PECOS. 
• Check the same web link as above for the "internet-based PECOS" (on the left). You must have previously set up your access, but if you are enrolled, your record will be displayed.
• Contact your designated Medicare enrollment contractor, also found on the same link as above but under the download "Medicare Fee-For-Service Contact information."

If you need information on how to establish an enrollment record in PECOS, check the CMS website at the following link: http://questions.cms.hhs.gov/app/answers/detail/a id/9909. (Information abstracted from CMS' Twitter account found on http://www.cms.gov/newmedia/.)

Betty Hatten is a manager in health care services at HORNE LLP. Her primary responsibilities include oversight of the chargemaster assessment and maintenance team, as well as providing charge capture audits, performance improvement assessments, and focused compliance reviews. Betty is a frequent seminar presenter and customizes presentations for clients, hospital associations, and professional organizations on the local, regional and national level.