It May Be Time to Re-Enroll In Medicare

In 2003 Medicare instituted its Provider Enrollment, Chain, and Ownership System (PECOS) to securely identify Medicare providers. Since then, it has been trying to get providers who were enrolled in Medicare prior to the creation of PECOS to re-enroll.

Physicians who receive requests for revalidation are given 60 days to respond. If they fail to respond, their Medicare billing privileges are revoked. At that point, if they wish to continue to see Medicare patients, they must re-enroll anyway.

But even if you don't receive a revalidation request from your Medicare contractor, you should probably re-enroll in Medicare. Beginning on January 3, 2011, Medicare will not pay for ordering or referring from providers who are not registered in PECOS. This applies to physicians who have opted out of Medicare as well, but since providers must opt out every two years, all of them should already be in PECOS. It should be noted that although you may not order or refer if you are not in PECOS, you will still be able to bill for your services (unless, as noted above, you have failed to respond to a request to revalidate your enrollment).

If you are not sure whether you are in PECOS, go to <www.cms.gov/MedicareProviderSupEnroll/06_MedicareOrderingandReferring.asp#TopOfPage>. Scroll down to the bottom of the page to the Downloads, and click on the Medicare Ordering and Referring File, which is a list of all providers registered in PECOS. At last check, it was 14,919 pages long.

If you're not on the list, you can enroll online at <https://pecos.cms.hhs.gov/pecos/login.do>.