Questions and Answers

Question: What is the Medicare PECOS system?

Answer: PECOS stands for Provider Enrollment Chain and Ownership System. PECOS is a national database of Medicare provider, physician and supplier enrollment information. PECOS is used to collect and maintain the data that is submitted on CMS 855 enrollment forms and can be used by Medicare carriers and other agencies throughout the United States. Although you have had a Medicare provider number for years, you probably were not registered with PECOS and therefore Medicare is requesting that you complete a new CMS 855I for that purpose.

Question: How long should we keep our patient sign-in sheets and should we highlight or cross out the patients name after they are treated by the physician.

Answer: Patient sign-in sheets should be kept for a minimum of seven years and office staff should never highlight or cross out patient names on the sign-in sheet. Medicare considers patient sign in sheets the most important proof that a patient was treated in your office. If Medicare ever wants to review the services rendered to a patient they always request the sign in sheet for the day of service the patient was treated.

Question: We are an internal medicine practice that moved to a new office about two months ago. We did the typical things that any business does when they move, which includes completing and submitting a forwarding address card to the postal service. Since we moved to our new office, Medicare stopped submitting checks to us. We called Medicare Customer Service and they advised us that since they were not notified of our new office, they would have to hold our checks until we complete and submit a variety of Medicare documents. We called Customer Service numerous times and were given different instructions. Can you provide us with advice on how to receive our Medicare checks? This is hurting our cash flow!

Answer: When you relocate to a new office or add an additional location, you are obligated to notify Medicare Provider Enrollment within 30 days. The post office returns these checks to Medicare. What you need to do is complete a CMS 855 application pertaining to this change of information and yournew practice location and pay to address. You also need to complete a CMS 588 EFT (Electronic Funds Transfer) form because Medicare will not mail you any more checks after you are caught up. Medicare now requires that payments be directly deposited into your group's bank account. Additionally, you may want to contact customer service to find out if you and/or any members of your group need to "revalidate" your PTAN numbers.

Question: May a physician or hospital "fax" a patient's medical information to other physicians or to an insurer?

Answer: Yes. HIPAA does not prohibit a "covered entity" from faxing protected health information. A physician should be sure, however, to limit the information in the fax to the minimum necessary information. Also, the physician's office should be sure to verify the recipient's fax number and use a cover sheet that does not include protected health information.