Instructions for the Implementation of the Internet-Based Provider Enrollment, Chain and Ownership System (PECOS)
MLN Matters Number: MM6231
Related Change Request (CR) #: 6231
Related CR Release Date: October 24, 2008
Effective Date: November 24, 2008
Related CR Transmittal #: R271PI
Implementation Date: November 24, 2008
Provider Types Affected
All physicians, providers, and suppliers who submit CMS-855 applications into the PECOS system via the Internet to Medicare contractors (Medicare Administrative Contractors (A/B MACs), Fiscal Intermediaries (FIs), Carriers or Regional Home Health Intermediaries (RHHIs)).
Provider Action Needed
This article is based on Change Request (CR) 6231 and alerts providers to the fact that the information about Internet-based PECOS applications provided in previously issued Change Request (CR) 5954 is now incorporated into Centers for Medicare & Medicaid Services (CMS) Medicare Program Integrity Manual Chapter 10─Medicare Provider/Supplier Enrollment, which is available at www.cms.hhs.gov/manuals/downloads/pim83c10.pdf on the CMS Web site. CMS emphasizes that none of the material in CR 5954 is changing in any way; the material is simply being shifted to Chapter 10.
Background
CR6231 describes the PECOS CMS-855 applications. Specifically, this directive incorporates all of the instructions contained in CR 5954 into the Medicare Program Integrity Manual Chapter 10─Medicare Provider/Supplier Enrollment. Consequently, CR6231 rescinds and replaces CR 5954.
Key Points of CR 6231
Effective immediately CMS has incorporated the instructions regarding PECOS applications into the Medicare Program Integrity Manual Chapter 10. The instructions are as follows:
- If the provider fails to submit a signed and dated certification statement to the Medicare contractor within 15 calendar days of the date on which it submitted its Internet-based PECOS CMS-855 to the contractor, the contractor may reject the application.
- For initial CMS-855 applications sent via the Internet-based PECOS, it is only necessary that the dated signature of at least one of the provider’s authorized officials be on the certification statement that must be sent in by the 15th day. The signatures of the other authorized and delegated officials will be collected through the normal application development process.
- If the provider submits an undated certification statement or a certification statement on which the Web Tracking ID does not match that in PECOS, the Medicare contractor will treat it as a non-submission.
- If your contractor determines that additional or clarifying information is needed, the contractor will send an e-mail to the provider: (1) requesting said data along with, as necessary, a signed and dated certification statement; and (2) listing a date(s) by which the information and certification statement, respectively, must be submitted to the contractor.
- Note that your contractor may, at its discretion, initiate a follow-up contact with you after sending the e-mail, but is not required to do so.
- If the provider fails to submit the requested additional/clarifying information and the accompanying certification statement within 30 calendar days from the date the contractor sent the e-mail, the contractor may reject the provider’s application.
- If the contractor receives the additional/clarifying information from the provider, the contractor will not recommence its processing of the application until the accompanying certification statement is received in the contractor’s provider enrollment department.
- The provider must submit all applicable supporting documentation (e.g., licenses, CMS-588) with its Internet-based PECOS application. (It is not necessary, however, for the provider to submit the supporting documentation: (1) in the same package as the certification statement, or (2) prior to its submission of the certification statement.)
Additional Information
If you have any questions, please contact our provider service center at our toll-free number, (877) 567-9249 (for North Carolina Part A and South Carolina Part A providers) or (866) 801-5301 (for home health and hospice providers).
For complete details regarding this Change Request (CR) please see the official instruction (CR6231) issued to your Medicare A/B MAC, FI, Carrier or RHHI. That instruction may be viewed by going to www.cms.hhs.gov/Transmittals/downloads/R271PI.pdf on the CMS Web site.
Disclaimer: This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.