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CMS Starts Screening Providers and Suppliers and Adds Site Visits and Fingerprint-based Criminal Background Checks to the Process

by Mary Pat Whaley | Mar 3, 2011 | Medicare & Reimbursement, PECOS

The Centers for Medicare & Medicaid Services (CMS) has the continuing goal of reducing fraud, waste, and abuse through all available avenues.  The Affordable Care Act requires CMS to determine the level of screening to be conducted during provider and supplier...

New Deadline (Sigh) Set for Medicare Claim Denial If Ordering/Referring Providers Not in PECOS

by Mary Pat Whaley | Dec 22, 2010 | Medicare & Reimbursement, PECOS

NOTE April 2011: CMS recently announced that July 5, 2011 will not be the date that claim editing will begin. *********************************************************************************** If you read my post on November 29th, you already know that CMS delayed...

Due to PECOS Backlog, CMS Announces Delay of January 3, 2011 Automated Edits & Claims Denial

by Mary Pat Whaley | Nov 29, 2010 | Medicare & Reimbursement, PECOS

NOTE: The date has been changed to July 5, 2011 delayed indefinitely. ************************************************************************************ The following statement was released by CMS on November 26, 2010: The Centers for Medicare & Medicaid...

The Dog Days of PECOS: CMS Publishes the Short Form (Paper) for PECOS, plus Consultant David Zetter Walks You Through It Online

by Mary Pat Whaley | Jul 25, 2010 | Medicare & Reimbursement, PECOS

NOTE: The date has been changed to July 5, 2011 has been delayed indefinitely. ************************************************************************************ Many managers have told me they know their providers are in PECOS but they’re not on the list OR...

Providers Without a PECOS Record Will Receive a Letter From Their Medicare Administrative Contractor (MAC)

by Mary Pat Whaley | Jun 8, 2010 | Headlines, Medicare & Reimbursement, PECOS

Note: MLN Matters published this link on June 9th that was inadvertently left out of the June 8th notice: http://www.cms.gov/MLNMattersArticles/downloads/MM6842.pdf ************************ On May 28, 2010, CMS in Change Request 6842 notified Medicare Part A & B...

My Notes from the CMS Open Door Forum on May 19, 2010: PECOS, DMEPOS and Blue Ink on Paper Forms

by Mary Pat Whaley | May 19, 2010 | Headlines, Medicare & Reimbursement, PECOS

CMS held a two-hour Open Door Forum today and there was so much good information shared that I thought I’d pass my notes from the call along to you. New EFT Form The revised EFT (Electronic Funds Transfer) authorization form 588 is available here (pdf.) The old...
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