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  • CGS Medicare
  • CGS Medicare
  • CGS Medicare
  • CGS Medicare
  • CGS Medicare

Provider Enrollment Alert – Issues Resulting from Recent Provider Enrollment, Chain and Ownership System (PECOS) Release

On June 30, 2019, PECOS Release 7.37 was implemented. This release was prescheduled and designed to bring efficiencies to Medicare Administrative Contractors (MACs) and providers who use PECOS. While many aspects of the release were successful, a small component associated to changes made to existing and new group reassignments was found to be problematic post-implementation. As a result, data flows from PECOS to the Multi-Carrier System (MCS) for these changes have been delayed for all MACs to proactively correct the identified issue.

CMS has assembled a team with accountability for resolving this issue. The team is working tirelessly to resolve the issue by July 16, 2019.

Potential Questions and Answers that you may have:

Q: Can I continue to submit enrollment applications?
A: Yes, please continue to submit applications as you do today. Internet-based PECOS applications are the quickest method of submission and processing, although you may submit either via Internet-based PECOS web or paper applications. Application processing will continue at each of the MACs as normal. Please also continue to respond to requests for additional information.

Q: My PECOS enrollment record has been approved, but when I attempt to enroll with EDI they indicate my provider/supplier is not present in the claims system. Is additional action needed on my part?
A: No, we will update this article when a fix has been deployed and at that time you can enroll with EDI.

Q: My PECOS enrollment record has been approved but when I submit claims, they cannot be processed because the NPI/PTAN is not present in the claims system. Is additional action needed on my part?
A: No, we will update this article when a fix has been deployed and at that time you can resubmit claims for processing.

What We Do

CGS Administrators, LLC (CGS) provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 24 million Medicare beneficiaries and 100,000 healthcare professionals nationwide. CGS operates as a Part A, Part B, Home Health & Hospice (HH&H), and Durable Medical Equipment (DME) Medicare Administrative Contractor for the Centers for Medicare & Medicaid Services (CMS).

More About Us

Headquartered in Nashville, TN, with offices in IL, SC, and TX, CGS’s more than 1,000 experienced employees provide services including healthcare claims processing and payment, customer service, provider credentialing, enrollment and education, medical necessity, pre- and post-payment review, as well as cost reduction through systems and process improvements.

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