Avoid claim rejections by fully updating your providers’ enrollment information in the Provider Enrollment, Chain, and Ownership System (PECOS) by July 6, 2010. The requirement was already slated to take effect on January 3rd 2011 as reference from our previous article named “New PECOS edits and how to prevent rejections”. The new health care reform legislation with contains language requiring some provision to be implemented within six months is probably the reason for the deadline being shortened to July 6, 2010 from January 3, 2011. CMS will accept public comments until July 6, 2010, since this is an interim final status with a 30 day comment period.
TIP:
Orders and referrals for home health services will be affected with this the new rule. Claim rejections may result when providers furnish items and services ordered or referred by outside providers who are not in PECOS. Written and electronic documents of orders and referrals are required whether you received them or issued them.
How ECP can help?
When providers send their claims to ECP, they are put through extensive preliminary edits. Catching potentials problems as stated in this article and much more before it is ever sent to the payer. ECP will hold a practices claim if it is missing required information. Practices will receive a report within 2 hours of their submission letting them know their status and if any additional information is need to process the claim with the payer.
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