decisionhealth Newsletters, Part B News - 2007 Issue 4 (April)
OIG: Contractor, providers faulted for PECOS delays
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Article Overview
This article discusses an HHS Office of Inspector General report examining why Medicare provider enrollment applications were delayed during the PECOS era. It focuses on the operational causes of backlogs, differences in contractor handling, and a later change to Medicare enrollment timing guidance. The piece is relevant to Medicare enrollment staff, billing and compliance teams, and providers affected by enrollment processing.
Why This Topic Matters
Enrollment delays can affect when providers can begin billing and participating in Medicare, so understanding the causes of PECOS-related backlogs is important for enrollment operations and compliance planning.
What You Will Learn
- The general causes of Medicare enrollment processing delays discussed in an OIG report.
- How contractor performance and provider responsiveness were described as contributing factors.
- That Medicare enrollment timing guidance changed in 2006 in relation to application completeness.
- Why PECOS-related enrollment administration matters to providers and billing operations.
Who Should Read This
- Medical coders
- Billing staff
- Provider enrollment specialists
- Compliance teams
- Healthcare administrators
- Medicare providers
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