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What is PECOS Certification? (Is PECOS Medicare or Medicaid)

Monday, July 13, 2020


Healthcare facilities are improving along with the advancement in technology. Consequently, this has lead to an increase in healthcare expenses to a considerable extent. There are two major public assistance programs for supporting patients to pay for their healthcare expenses - Medicare and Medicaid.

Medicare is an initiative taken by the federal government for providing healthcare facilities with insurance to senior citizens and people with severe illness or disabilities. On the other hand, Medicaid is a joint initiative taken by the state and federal government to provide health insurance to people with a meager income level.


Medicare and Medicaid

These two programs follow a similar approach, and their main motive is to help people bear their medical expenses. Both of these public assistance programs undertaken by the government are designed to help people in their hour of need.

Medicare is mostly valuable for senior citizens above 65 years, whereas Medicaid is specially designed for people with a low-income group. Medicaid is paid in the form of public taxation and funding after obtaining healthcare assistance, whereas Medicare is offered to senior citizens as a health insurance facility.

Enrollment in Medicare

You can enroll in the public assistance program (Medicare) in two ways. You can utilize various Medicare paper applications with the help of PECOS certification. PECOS is a highly secure website for insurance providers and healthcare suppliers and is an excellent alternative to paper-based registration.

Apart from the facilities of online registration, the data gets recorded and verified through online sources. The entire process is transparent and can be electronically accessed and transmitted for real-time updates and modifications. Apart from that, the online portal calls for fewer mistakes due to human or manual errors in the paper-based enrollment process.

PECOS System

The Provider Enrollment, Chain, and Ownership System (PECOS) is incorporated by medical billing companies for the Medicare filling system. It is a national database operated electronically for retaining and recording valuable information for all the Medicare-enrolled suppliers and providers.

It includes the list of all the registered and non-registered physicians who can refer patients to get enrolled in Medicare. CMS designed the PECOS framework to combat any incidence of abuse and fraud.

The enrollment process for the suppliers and providers of Medicare involves submitting a paper-based application or the internet-based PECOS certification.

The certification has been developed for protecting the rights of the employees working under PECOS and respecting the Patient Protection and Affordable Care Act. All the physicians who care for the patients enrolled under Medicare should get themselves enrolled in PECOS and keep the certifications for reference.

It does not cost a penny and follows a straightforward process of registration. The physicians should revise the PECOS status on a regular basis. Other professionals such as social workers, nurses, midwives, psychologists, nurse practitioners, certified specialist nurses, and assistants of physicians can also enroll in PECOS.

PECOS Certifications

In order to obtain PECOS certification, internet-based PECOS registration is mandatory. Firstly, an enrollment application must be submitted for Medicare, followed by changes and modifications in the enrollment information if necessary. After the web submission, the status can be tracked regularly for reassignment of benefits.

The Medicare program can be reactivated and additional changes can be made. Users can withdraw themselves from the program if there is a necessity or change of ownership of the Medicare enrollment provider.

PECOS Enrollment

PECOS is designed for registering and retaining medical data for all the suppliers and providers of Medicare. For the enrollment process, you can follow either of these two options - paper-based conventional registration process or internet-based process.

For internet-based enrollment, the applicant must create an account in CMS Identity for Access Management System before logging into the PECOS application portal. After creating a PECOS account, the user should upload all the required documentation such as National Provider Identifier (NPI), Drug Enforcement Agency (DEA) number, and another qualification proves. With proper enrollment type, all the data can be transferred to Medicare for enrollment.

The paper version of enrollment is done by downloading the form available on the CMS website. All the criteria should be filed electronically, then it can get printed and signed for approval. The signed form is then contacted for processing.

The option of the paper-based enrollment process is lengthy and cumbersome. On the other hand, online registration is easy and convenient. The processing time for internet-based PECOS certification takes about a maximum of 45 days for completion, whereas the paper-based registration requires a minimum of 60 days.


Conclusion

PECOS certification for Medicare gives more control over the reassignments and revision of the medical details and asks for regular updates to keep all the information worthy.
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