Medicare Revalidation

Medicare PECOS Enrollment Revalidations Resume Oct. 2021

On October 3rd, CMS announced that it is resuming Medicare revalidations of provider enrollment information in the PECOS system in October 2021. If you are an existing Medicare provider and missed your revalidation due date because of the Public Health Emergency (PHE) deferral, CMS will be implementing these in phases. Effective October 31st, Medicare Administrative Contractors (MACs) and National Supplier […]
Identity and Access Management System

Make Medicare Enrollment Easier and More Efficient with a CMS I&A account

CMS’ Identity and Access Management System (I&A) allows you to manage your providers’ Medicare enrollments and related online activities more easily and efficiently.   Until a few years ago, you were required to have a separate username and password for each of the CMS’ online systems necessary to ensure your Medicare enrollments and reimbursement.  To compound […]
Medicare Participating Provider

Medicare PAR vs Non-PAR: Reduce Hassle and Boost Cashflow

Choosing the wrong Medicare participation status for your provider can have significant financial consequences for your practice. Your choices are a Medicare Participating Provider (PAR) or a Medicare Non-Participating Provider (non-PAR). If you make the wrong choice, your allowable reimbursement can be limited, or you can end up unable to get paid by Medicare at […]
PECOS login

Accurately Choose Your PECOS Login Surrogacy Designation

CMS rules do not allow you to use your provider’s login credentials to manage their Medicare enrollment and ongoing revalidations in PECOS (Provider Enrollment, Chain, and Ownership System). There is a more efficient, compliant process you should be using to manage this. PECOS login. To be compliant, you must set up a PECOS login surrogacy […]

Use PECOS to Speed Up Medicare Enrollment Efficiency

Whether you’re enrolling your provider with Medicare for the first time or responding to a revalidation request, knowing how to correctly utilize CMS’ Provider Enrollment, Chain, and Ownership System or PECOS Medicare enrollment system is essential. What is the PECOS Medicare Enrollment system, anyway? PECOS is an internet-based enrollment process that provides you with an […]
credentialing and enrollment

Master the Differences Between Provider Enrollment & Credentialing

Interchanging the terms credentialing and enrollment is a surefire way for your provider reimbursement to take a serious hit. The problem is that there is definitely overlap between them. Ultimately, however, having a solid understanding of each process and knowing the differences between provider enrollment and  credentialing is the only way to more efficiently and […]
CAQH ProView Portal

CAQH ProView Portal: Make Credentialing/Enrollment Faster & Easier

Your patients pay for their health insurance and want to use it. This means that if you want to treat them, you need to be enrolled in their health insurance plan. Participating in insurance networks almost certainly guarantees you will be required to utilize the Council for Affordable Quality Healthcare (CAQH) ProView Portal, and it […]
Practice's Worth

Prove Your Practice’s Worth to Payor and Reap the Financial Reward

Payors may not come right out and ask you to prove your practice’s worth but being able to do so can have a significant impact on your bottom line. practice’s worth. Proving your worth to a payor can get you reactivated after you’ve been excluded from a plan or get you in the door after […]
CAQH Profile

Comply with 2021 CAQH ProView Changes & Avoid Payment Delays

Keeping your provider credentialing up to date is critical to your practice’s financial success, and your CAQH profile is a big piece to that puzzle. 2021 is bringing significant updates to CAQH ProView that you can’t afford to miss. It’s imperative that you get a handle on these changes now otherwise you’ll feel it in […]
Physician Credentialing

Physician Credentialing: Prevent Cash Flow Break with NPI Accuracy Essentials

Make no mistake! Setting up and maintaining the accuracy of each of your physician’s National Provider Identifier (NPI) is essential and COMPLEX. Any error on your NPI application will result in your reimbursement being delayed and a hit to your practice’s cash flow. As a Medicaid/​Medicare provider, you are required to obtain a NPI to […]