tci Medicare Compliance & Reimbursement - 2014 Issue 3

PECOS System: Take 8 Steps to Avoid PECOS Rejections

PECOS edits are finally switched on. Just when healthcare providers were beginning to think that Phase 2 of the PECOS edits was going to be canned, CMS went live with it on Jan. 6. Rejections have been quick to follow. Here’s what you can do to avoid being part of the losing end of this development.. Background: In today’s Medicare environment, you certainly can’t afford to have payments denied or rejected, but effective Jan. 6, if your physician performs a service as the result of an order or referral, your claim must include the ordering or...

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