Attention all HAS Clients:

Important Update on PECOS & Ordering/Referring

Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed.   These edits would have checked certain claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National Provider Identifier (NPI). If this information were missing or incorrect, the following types of claims would deny:

• Claims from laboratories for ordered tests;
• Claims from imaging centers for ordered imaging procedures; and
• Claims from suppliers of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) for ordered DMEPOS.
• Claims from Part A Home Health Agencies (HHA)

CMS will advise you of the new implementation date in the near future. In the interim, informational edits will continue to be sent for those claims that would have been denied had the edits been in place.

If you are using HomeCare Accounting Solutions’ HBS Billing application, we have a built-in PECOS check feature that you may not be aware of (See Attached PECOS FAQ.docx). We have enhanced this feature to mark all PECOS-enrolled Physicians with today’s date. You must be on version 1.2.6.35 to use this new feature. The newest version of the PPS Exception report will report a failure if the Doctor is not marked as PECOS-enrolled which will ensure that no claims are sent out unless the Doctor is verified.

If you have any questions please feel free to contact HAS Support.

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