Tag: PECOS

Hospice Claims Incorrectly Returned to Provider

Some hospices are seeing claims Return to Provider (RTP) due to a problem with the attending physician’s National Provider Identifier (NPI).  Transmittal 11633/Change Request (CR) 12889 which instructs MACs to have an edit that validates the attending physician’s NPI includes hospice claims and should not.  The CR instructs MACs to validate the NPI in the Attending…

Physicians Practicing with an MBBS Degree

The National Association for Home Care & Hospice (NAHC) has increasingly been receiving questions regarding whether a practitioner with an MBBS credential is permitted to certify and order services for home health patients. It was noted that many of these practitioners have an enrollment record in the Provider Enrollment, Chain, and Ownership System (PECOS). NAHC…

Home Health Quality Update

Many health agencies have experienced problems in the iQIES system that affected how Services Provided values for their agencies were displayed on the HHA Provider Preview reports distributed in February and on Care Compare. (See NAHC Report for more information.) The Center for Medicare & Medicaid Services (CMS) recently released a notice about the systems transition…

Reminder: CMS Resumes Application/Revalidation Fees

The Provider Enrollment Chain and Ownership System (PECOS), the online Medicare enrollment management system which allows you to enroll as a Medicare provider or supplier, will resume collecting application fees for all institutional providers and suppliers that are initially enrolling, revalidating or adding a new practice location. The Centers for Medicare & Medicaid Services (CMS) recently announced it…

CMS Updated Provider Demographic Data Process

The Centers for Medicare & Medicaid Services (CMS) will be transitioning to a new data source for a provider’s demographic data for hospice and home health agencies as well as other Post-Acute Care (PAC) provider types (Skilled Nursing Facilities / Nursing Facilities (SNF/NFs), Inpatient Rehabilitation Facilities (IRFs), and Long-Term Care Hospitals (LTCHs)). While not specified…

CMS Extends Moratoria on New Home Health Agencies in Key States

The Centers for Medicare & Medicaid Services (CMS) announced today it will extend and implement temporary enrollment moratoria on home health agencies (HHAs) for all counties in the states of  Florida, Illinois, Michigan, and Texas, as well as Part B non-emergency ground ambulance providers and suppliers for all counties in New Jersey and Pennsylvania. The…