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David McGill Blogger

A PECOS Resource

Posted by David McGill | January 17, 2014

​On December 12th, we reminded you that Medicare would start rejecting claims submitted after January 6 if the prescribing physician did not appear in the PECOS database. At that time, we included a link to Medicare's PECOS files, which you could manually search to confirm the doctor's PECOS status. While accurate and complete, they are a bit unwieldy given their size and format (Excel or PDF).

Our friends at oandp.com let us know that they have created a tool that may save you some time and energy in that regard. We have tested it and recommend it to you.

How does it work?

  1. Go to oandp.com's PECOS search tool
  2. Plug in the physician's name and state. The tool will either confirm or "red flag" the entry.

That's it.

I put the tool to the test, typing in my doctor's name followed by the initials of my state. It instantly produced a confirmation that my physician is PECOS enrolled. I then did the same thing for a doctor I know with a very common name. The tool produced numerous results - 3 physicians in NY with the name who were enrolled with PECOS and many more who were not. By clicking on the enrollees' PECOS numbers, I was able to then figure out which doctor was "mine" by matching the name to the correct address.

oandp.com monitors updates to the PECOS-enrolled physicians spreadsheets, which currently occur on roughly a weekly basis. It typically uploads the new data within 1 business day of it becoming available. 

What does this mean for you?

Based on our testing of the tool, oandp.com's PECOS search tool is an easier, quicker way to confirm your physician's PECOS status than manually searching Medicare's spreadsheets yourself. 

But if you're looking to go a step further and get absolute "maximum PECOS efficiency," we recommend checking with your practice management software company. We know at least one of the major software companies in the O&P industry has a built-in tool that automatically confirms your doctor's PECOS status without you having to do anything. If your software doesn't have that functionality, that alone might be a reason to switch. Remember: if you file a claim but your physician isn't PECOS-enrolled, you won't get paid, regardless of how good your documentation is.

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