New PECOS Enrollment Deadline for Pathologists and Referring Physicians
CMS has recently announced that it has moved the date for enrollment in PECOS up six months to July 6, 2010. PSA is hopeful that, while the regulation now requires providers to be enrolled in PECOS by July 6, 2010 the Medicare carriers will not begin denying claims before the originally published date of January 3, 2011.
CMS has refused to clarify whether or not they would continue to pay claims for physicians if both the physician and referring provider are not enrolled in PECOS by July 6, 2010. Therefore, PSA will continue to monitor the status of PSA client enrollment with CMS and encourages our clients to continue contacting their referring physicians regarding enrollment.
Background
Medicare will discontinue paying claims for physicians if both the physician and referring provider are not enrolled in PECOS (Internet-based Provider Enrollment, Chain and Ownership System). It is important to understand that enrollment in PECOS is a separate process from traditional Medicare enrollment. Although enrolled in Medicare, many physicians are not enrolled in PECOS. The January 3 2011 deadline, which was announced last year, has been moved up to July 6, 2010.
PSA Client Enrollment
PSA confirmed that 55% of our affiliated pathologists were already enrolled in PECOS. PSA has submitted PECOS enrollment forms for all PSA pathologists who were not already enrolled. As of June 1, 57% of these enrollments have been processed by CMS. The carriers have informed PSA that due to a backlog of enrollment packages received in recent months, their timeline for processing the remaining enrollment packages has been pushed out from 60 to 90 days. PSA will continue to monitor and keep our clients updated on their enrollment status.
Referring Physicians Enrollment
Due to this uncertain deadline and backlog in enrollment processing, PSA is encouraging our clients to contact their referring physicians immediately regarding enrollment. At present claims for PSA billing clients are being processed normally but we have begun receiving warning messages from some carriers indicating that many of our client's referring physicians are not enrolled in PECOS or otherwise not found in the carrier's claim systems. PSA will continue to provide our clients with a listing of referring physicians for which we receive these warning messages as this information is made available to us by the carriers.
Additional Resources
In order to assist in educating your referral sources, PSA has developed a handout which can be personalized with your practice's logo and contact information. PSA also held a conference call to discuss referring physician enrollment with clients in April. A copy of that conference call is available on the PSA Extranet for affiliated clients.
If you have questions or would like additional information please contact your PSA billing office or Leigh Polk at 800-832-5270 x 2941 or lpolk@psapath.com.