Outpatient Facility Coding Alert - 2014 Issue 7
Physician Note: NPs Without Masters' Degrees Face Issues With PECOS
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Article Overview
This article covers a Medicare administrative problem involving nurse practitioners, PECOS enrollment, and ordering/referring privileges. It is relevant to practices, office managers, compliance staff, and coding/billing professionals who handle Medicare provider enrollment and related credentialing questions. The piece summarizes a CMS response from an Open Door Forum and highlights an unresolved enrollment issue that may affect certain practitioners.
Why This Topic Matters
Provider enrollment and ordering/referring access can affect whether claims and referrals move smoothly through Medicare workflows. Understanding this issue helps practices anticipate enrollment obstacles and monitor CMS guidance.
What You Will Learn
- How PECOS enrollment concerns can affect nurse practitioners
- Why Medicare provider enrollment requirements may create administrative barriers
- What CMS said in response to a question raised during an Open Door Forum
- Why practices should monitor future CMS guidance on this issue
Who Should Read This
- Physician practices
- Office managers
- Medical billing staff
- Compliance professionals
- Provider enrollment staff
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