Open Close

BLOG SIGNUP Open Close

BLOG SIGNUP

From regulatory news to best practices, subscribe to our blog to stay informed.

PECOS Provider Validation 

What is PECOS?

PECOS, or Provider Enrollment, Chain and Ownership System, simplifies the Medicare Provider and Supplier enrollment process through an online enrollment system which allows users to securely submit, manage, view, and print Medicare enrollment information. The online PECOS system made Medicare enrollment completely paperless and made it much easier to check and update your information.

Since January 6, 2014, Medicare has denied claims for services or supplies that require an order/referring provider to be identified, but the provider is not identified, not in Medicare’s enrollment records or is not of a specialty type that may order or refer the service/item being billed. So staying on top of your PECOS verification is a key step in avoiding Medicare denials.

​Have a PECOS National Provider ID?     PECOS Verification Below:

This PECOS verification tool provides a way to verify your referring physician against the most recent CMS public-use file (the date of the file is shown in the table) to make sure they have enrolled before accepting the patient onto your services.

The reports produced by this Web application are based upon the input data entered by your company and our interpretation of the regulations. The accuracy and reliability of these reports is dependent upon the accuracy and reliability of your input data and the accuracy and reliability of the regulations and public use files as provided by CMS.

All reports should be reviewed and interpreted by a competent professional in the context of your particular business situation. The sponsor(s), manager(s), owner(s), and/or any party associated with this service and/or any of its products, in any form or media, shall not have any liability for the accuracy, any conclusions drawn, or decisions made based on such products.