USAGE OF PECOS System – Provider Enrollment, Chain, and Ownership System

The Medicare Provider Enrollment, Chain, and Ownership System (PECOS) is an online provider and supplier enrollment system used to:

** Submit Medicare enrollment applications
** View and print enrollment information
** Update enrollment information
** Complete the enrollment revalidation process
** Withdraw voluntarily from the Medicare Program
** Track Medicare enrollment applications

This booklet teaches Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) suppliers how to use PECOS. Go to the Medicare Provider-Supplier Enrollment National Educational Products listing for information about other provider types.

DMEPOS SUPPLIER STANDARDS, ACCREDITATION, AND SURETY BOND

To enroll or keep your Medicare billing privileges, all DMEPOS suppliers (except certain exempted professionals) must meet supplier and DMEPOS Quality Standards to become accredited. Certain DMEPOS suppliers must also submit a surety bond.

DMEPOS suppliers (except for those exempted eligible professionals and “other persons”) must be accredited prior to submitting a Medicare enrollment application to the National Supplier Clearinghouse (NSC). For more information on these conditions, go to the Centers for Medicare & Medicaid Services (CMS) DMEPOS Enrollment webpage or review the DMEPOS Accreditation fact sheet, which lists exempted eligible professionals.

ONE ACCOUNT, MULTIPLE SYSTEMS

CMS uses several provider enrollment systems. Organizational DMEPOS suppliers must use the Identity & Access Management (I&A) System to name an Authorized Official (AO) to work in CMS systems. The I&A System allows you to:

** Use the National Plan and Provider Enumeration System (NPPES) to apply for and manage National Provider Identifiers (NPIs)

** Use PECOS to complete Medicare enrollment or update or revalidate your current enrollment information

** Register to get Electronic Health Record (EHR) incentive payments for eligible professionals and hospitals who adopt, use and upgrade, or demonstrate meaningful EHR certified technology use Individual DMEPOS Suppliers (for example, sole proprietorships) Physicians and non-physician practitioners (NPPs) who are DMEPOS suppliers may use their I&A System user ID and password to access PECOS. If you do not already have an I&A System account, go to the I&A System User Registration page and enter the information to open an account. For help, go to the I&A System Quick Reference Guide and click the “How to Setup Your Account if you are a Sole Owner” link.

Once you have your DMEPOS ID and password, skip to Step 3. As an individual DMEPOS supplier, you do not need an AO or other delegated user.

Organizational DMEPOS Suppliers System Users

CMS allows various types of organizations and users to work in their systems. The type of user  depends on the individual’s relationship with you and the duties they perform in your practice. A  DMEPOS supplier organization must appoint an AO to act on behalf of the organization to manageconnections and staff, including appointing and approving other authorized PECOS users. The organization must identify the AO in the enrollment application. The AO must have ownership or managing control in the DMEPOS supplier organization.

NOTE: CMS recommends using the same I&A System-appointed AO and any Delegated Officials (DOs) in PECOS. The AO and DOs must have the right to legally bind the company, are responsible for approving the system staff, and are approved in the I&A System based on their PECOS status. For more information go to the CMS External User Services (EUS) answers to frequently asked questions webpage.

STEP 1: AUTHENTICATE AO CREDENTIALS

The organization must choose, invite, and authenticate you as their “Authorized Official” (AO) to work in PECOS for them. That individual must meet the AO regulatory definition. An AO is, for example, a chief executive officer, chief financial officer, general partner, chairman of the board, or direct owner to whom the organization gives the legal authority to enroll it in the Medicare Program.

Respond to your employer’s AO invitation or initiate the request yourself. When you are the confirmed AO, use PECOS for your organizational DMEPOS supplier. You may choose to give this responsibility to a DO, Staff End User (SEU), or surrogate. As an AO, you are responsible for approving system user requests to work in PECOS for the organizational DMEPOS supplier. Regularly check your email and take the requested actions. AOs may also appoint DOs to act for them. For more information on registering for an I&A System account or enrolling as an AO, go to the I&A System Quick Reference Guide and the I&A Frequently Asked Questions (FAQs) and click the “Create Your Account” link.

ENTER PECOS ENROLLMENT INFORMATION
After CMS approves your I&A System registration, submit your organizational DMEPOS supplier application. PECOS is a scenario-driven application—it presents a series of questions to recover only the information needed to process your specific enrollment scenario. Follow these instructions:

1. Log in to PECOS.

2. Continue with an existing enrollment or create a new application.

3. When PECOS determines your enrollment scenario and you confirm it is correct, it shows the topics for submitting your application. To complete each topic, enter the necessary information.

4. At the end of the data entry process, PECOS: Confirms you entered all necessary data Shows a list of the Medicare Administrative Contractor/National Supplier Clearinghouse (MAC/NSC) documents to submit for review (the NSC is the MAC responsible for processing all DMEPOS applications)


STEP 4: RESPOND TO MEDICARE CONTRACTORS’ REQUESTS FOR MORE INFORMATION

Respond to information requests within 30 days; otherwise, the MAC/NSC may reject your enrollment.

Your MAC/NSC will not complete processing your PECOS enrollment application without your electronic signature, application fee, and necessary supporting documentation. The effective application enrollment filing is the date the MAC/NSC gets your electronic signature.

You can check your PECOS enrollment application status in two ways:

1. Log in to PECOS and click the “View Enrollments” link. In the “Existing Enrollments” section, find the application. The system shows the application status.

2. To see your enrollment status, go to the PECOS homepage and click “Application Status” under “Helpful Links.” You do not need to log in to PECOS to use this application status feature.

STEP 5: KEEP YOUR PECOS ENROLLMENT INFORMATION UP TO DATE Report a Medicare enrollment change using PECOS. You must report a change of ownership or control, a change in practice location, and any final adverse legal actions (such as revocation or suspension of a Federal or State license) within 30 days of the reportable event (go to the PECOS FAQs for a definition). Submit all other changes within 90 days of the reportable event. For more information, go to the MLN Matters® Article, Timely Reporting of Provider Enrollment Information Changes.

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