The speculation on whether PECOS-related edits will deny your claims as of July 6, 2010, is maddening. The most we can say for certain is that it’s a possibility, and could be enforced retroactively.
Scary, huh? Even more frightening is that I can’t think of any business analogy of one party being denied reimbursement for services rendered due to the direct (in)action of another party, whose reimbursement is totally unaffected. Am I missing something here?
Now, on top of that scenario, CMS may allow your reimbursement prescribed by a non-PECOS enrolled provider after July 6. And then, some time this autumn, they can say, “You know what, Mr. HME? We’re a bit short on funds, so we’re going to reverse those claims from July 6 forward.”
Besides unifying behind a strong lobbying force like the AMA, the best you can do is use the best tools available to you to prepare for the worst-case scenario. I believe that includes our Web Edition HME software. Here’s why:
- you add physicians and their accurate NPIs directly from the NPPES database;
- you’ll know immediately whether a physician is PECOS-enrolled; and,
- you’re as efficient as possible, because you never leave Web Edition to get the accurate information you need.
Each PECOS-enrolled physician is highlighted with a green background in the physicians’ smart lookup. Plus, when you select a prescribing physician for an order, you’ll automatically see a "PECOS Enrolled" message display with a green background.
We can’t force physicians to comply with PECOS any more than we can show CMS that dumping on home care actually raises health care costs. However, we could help you get the PECOS enrollment information you need faster. So we did.
