PECOS

The Provider Enrollment, Chain, and Ownership System is the online portal used by healthcare providers to enroll in Medicare and manage their Medicare enrollment records.

PECOS is where every Medicare enrollment starts and ends. It is the CMS system for submitting, tracking, and managing your Medicare provider enrollment. If you want to bill Medicare, you go through PECOS. The process works like this: you create an account on the PECOS website, complete the appropriate enrollment application (CMS-855I for individual providers, CMS-855B for group practices, CMS-855A for institutional providers), submit it electronically, and then mail a signed certification statement to your Medicare Administrative Contractor. Yes, even though the application is electronic, you still need to mail a wet signature. CMS has been talking about eliminating this requirement for years. PECOS replaced paper-based Medicare enrollment applications in 2003. Before PECOS, enrolling in Medicare meant filling out lengthy paper forms and mailing them to your MAC with stacks of supporting documentation. The system is not perfect, but it is significantly faster than the old paper process. Common reasons PECOS applications get rejected or returned include: missing or inconsistent information between the application and supporting documents, expired licensure at the time of submission, incomplete practice location information, and failing to link individual enrollments to group enrollments correctly. One thing that catches new providers off guard is the revalidation requirement. Medicare requires providers to revalidate their enrollment every five years (three years for DMEPOS suppliers). CMS sends you a revalidation notice, and you need to log into PECOS and confirm or update your information. If you miss the revalidation deadline, your Medicare billing privileges get deactivated. PECOS applications are processed by your regional MAC, and processing times vary. The official CMS target is 60 days for initial applications and 30 days for revalidations, but actual times can be longer during peak periods. Check your application status in PECOS regularly and respond immediately to any development requests from the MAC.