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Home Health & Hospice Week

Reimbursement:

PECOS Edit Delay Gives Providers Breathing Room

Published on Wed Sep 15, 2010

Stay on your docs to enroll, however. You now have an extra six months to avert a cash flow crisis brought on by your referring physicians failing to enroll in PECOS. Old: The Centers for Medicare & Medicaid Services had set the phase 2 PECOS physicianedits to begin in January 2011. The edits verify whether the ordering/referring physician listed on the home health agency claim has a valid National Provider Identifier number and is enrolled in the Internet-based Provider Enrollment, Chain and Ownership System. In phase 1, the edits merely send an informational message telling providers the requirement isn't met. In Phase 2, the edits will reject claims if the listed physician isn't enrolled in PECOS. New: Now CMS has pushed back the phase 2 edit implementation date to July 5, 2011, according to Oct. 8 Transmittal No. 781 (CR 6856). "The delay of phase 2 is a good thing," [...]
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