Credentialing
By Machelle Giordon, Credentialing Specialist
Medicare PECOS System
Medicare has most likely already sent you a letter regarding the Medicare PECOS system. If you have not updated your Medicare Enrollment application within the past five years, you will need to do so by December 31, 2009.
If a physician has not updated their information, it is not loaded in the Medicare PECOS system, which is used to pay physician claims. You need to contact Medicare to confirm this. They will instruct you as to which 855 enrollment application will need to be completed to be entered into the Medicare PECOS system.
You will also need to complete a Medicare Enrollment Application (855) form at least every three years. Merely updating or completing a CAQH application does not comply with this Medicare requirement.
O’Sullivan Consulting Group can assist providers in dealing with some of the additional demands of managed care plans and credentialing. For further assistance please contact Machelle Giordon at 330-723-2111 or machelle@osullivanconsult.com.
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