Music
Hello and welcome to one of our PECOS demonstrations. In this
demonstration, we will be walking you through one example of submitting an
organization application in PECOS. The example I'll be showing you here today
demonstrates a user submitting an application for a group clinic called Primary
Health Clinic. So if the organization you are submitting on behalf of is not a
group clinic, please keep in mind that the steps for beginning and completing
your application will be very similar to what we'll be showing here, and will
have many of the same screens. In order to actually begin this application,
we'll have to log in to the PECOS home page. To obtain your log in credentials,
and find other helpful information regarding Medicare and the application
process, please visit the PECOS home page. Now, I'm going to log in and begin
the application process.
First, you have to select the My Enrollments button located on the
left hand side of the screen. You'll then be able to select the New Application
button located over here on the left. You'll then be brought to the Applicant
Identification page. On this screen, you'll be shown your employer information
as a label and any organizations that you have access to submit applications on
behalf of. [Presenter selects the provider and then selects the "Next Page"
button.] On this screen, you will need to indicate the state in which the
organization that you were submitting on behalf of provides healthcare services.
In this example, Primary Health Clinic provides services in California. So
that's what we'll select here.
On this page, you are being prompted to indicate whether or not the
organization you are submitting the enrollment for is a supplier of durable
medical equipment. For the purpose of this demonstration, we will be selecting
No since Primary Health Clinic is a group practice and does not provide such
supplies. We'll go ahead and select the Next Page button. Now, you are brought
to the Primary Medicare Services Rendered page where you will need to specify
what type of services the organization provides. As we stated in the beginning
of our demonstration, Primary Health Clinic is a clinic group practice. So we'll
go over here to the Part B Supplier Services section and locate that from the
drop-down. I'll go ahead and select the Next Page button now. Next, you'll be
brought to a screen that asks you if the organization you are submitting for is
an Indian Health Service or IHS. For this demonstration, I'll select No and move
forward. Now, you are brought to the New Group Application screen.
This screen serves to inform you that in addition to the current application
being completed, each member of that organization must also enroll in Medicare
and reassign their benefits. After, you can move forward by clicking on the Next
Page button at the bottom of the screen. So finally, we've completed the initial
setup questions for this enrollment, and you can now verify on the screen before
beginning the application that the information here is correct and accurate for
your organization. After verifying this information, you can go ahead and click
on the Start Application button at the bottom of the screen.
At this point in time, we are now ready to begin completing each of the
sections needed to submit the Medicare application form. Before beginning this
application, please note some key features located at the top of the page.
First, we have the progress bar which shows you how close you are to completing
your enrollment application. Additionally, there are three tabs also located at
the top of the page to help you in browsing. The first is the Topic View page
which conveniently gives you a high-level view of all that needs to be completed
and shows check marks next to the sections that are already done. The Fast Track
View shows all of these sections within one page as well including the
information already entered.
Lastly, there is the Error/Warning Check tab which shows you what is still
outstanding to be completed within your application and any errors the system
finds in what you've entered. Note that the red number shown in the tab will
decrease as you address each item listed on that tab.
To begin the application, we'll go ahead and select this organization
information hyperlink. And we'll now have to select the Add Information button
to begin our data entry. On this page, we'll see the legal business name and tax
identification number of our organization shown as a label, and other fields
ready and accessible for data entry, such as the effective date of TIN, which
I'll go ahead and enter now. Next, you will be taken to the IRS
Proprietary/Nonprofit Status page.
For the sake of this example, we're going to select that Primary Health Clinic
as a proprietary business, and we'll hit the Next Page button to move forward.
Next, you are brought to the Organization Structure page, where you will need to
enter the type of organization structure for the organization enrolling in
Medicare. Because Primary Health Clinic is a partnership, I'm going to navigate
over to this drop-down, select Partnership, and move forward by hitting Save.
You are now navigated to the Topic Summary screen for organization information,
and you can see all of the information that was just entered on the previous
screens here as a label. If you need to edit any of this information, go ahead
and click the Edit button here. If not, you can move forward by selecting the Go
to Error Check button or the Return to Fast Track button below.
I'm now going to navigate back to the Topic View by selecting the
Topic View tab at the top of the screen, and you will notice that the
Organization Information section now has a check beside it. We can move forward
to the next section, the Supplier Type section by clicking the hyperlink here.
We were now brought to the Supplier Type Summary page where we can see that
Clinic/Group Practice has already been entered. This is the information we
entered at the beginning of our application and you can see it here as a label.
To move forward, you can select the Next Topic button at the bottom of the
screen. The final section we are brought to is the Required and/or Supporting
Documentation section.
Here, you can designate that you wish to upload supporting documentation with
your enrollment application. For this example, we are going to select Yes and
we're going to upload a PAR Status Information form, the CMS-460 form. To do
this, we'll need to navigate down to the bottom of the screen and select the
document type before moving forward. All of the documents that are available for
upload, you can see are listed and shown on the screen here. We'll select this
one, CMS-460 form, and select the Browse button to locate this document.
When you are ready to upload your document, go ahead and select the
Upload button shown here. After doing this, you can scroll to the bottom of the
page to ensure that your document did indeed get uploaded. If you need to make
any updates or you accidentally uploaded the wrong document, just go ahead and
remove it here. If you'd like to confirm that it didn't indeed get uploaded
properly, select the View button here. For now, we're going to move on by
selecting to the Return to Topics button at the bottom of the screen.
As you can see, all of the topics that are required to begin submitting this
application have now been completed, and all have check marks associated with
them. If you look at the top of the screen, you'll see the my application
progress bar which shows you're very near close to completion, we are at 90
percent, which means you're close but not there yet. Additionally, you can click
on the Error/Warning Check tab again, and you'll see that there are no errors or
warnings associated with this enrollment. We're now ready to click on the Begin
Submission button located at the bottom of the screen shown here.
The first thing you'll see after having selected the Begin Submission
button on the previous screen is the Electronic Signatures option. For this
enrollment application, that means I would be opting to E-sign the Certification
Statement and the Electronic Funds Transfer information. So I'm going to go
ahead and select Yes to continue. You will be then shown a screen called the
Signatories for Authorized Official Screen where you will need to enter the
e-mail address information for the authorized official you listed previously in
the application. This authorized official will receive an e-mail that the
enrollment application being submitted needs to be electronically signed.
You'll next be brought to the Signatories for Authorized Official's page where
you will need to enter e-mail information for the authorized official you
entered previously in the enrollment application. The person listed here will
receive an e-mail stating that they need to electronically sign the enrollment
application before the Medicare administrative contractor can begin processing
that enrollment. Here, I'll enter in the e-mail address information, and then
I'm going to select the Authorized Official as the signer, hit the Apply button,
scroll down and select the Next Page button to move forward.
The next page in this submission process is the Contact and Processing page
where you will select the Medicare administrative contractor who will be
responsible for processing the enrollment application. Select that contractor
from the drop-down and hit the Apply button. You'll then see the contractor's
information shown here as a label, and you can review required and supporting
documentation with the information that's shown here on the screen, and you can
also scroll down to the bottom of the screen to view the document that was
uploaded as a portion of the Electronic Documents section. And if anything needs
to be changed before you submit your application, you can select the Previous
Page button located here.
Since I'm ready to submit my application, I'm going to hit the Complete
Submission button to submit this over to my Medicare administrative contractor
for processing. The next thing you'll see in submitting your application is a
pop-up box that shows that any required documentation that needs to be mailed
that was not electronically uploaded must be mailed in to your contractor.
Otherwise, you will run the risk of your enrollment being delayed for
processing. Once you've recognized this fact, you can hit the OK button. And
here, you'll see all of your pertinent information regarding your submission.
This is your Submission Confirmation, and it is wise to print this receipt for
your personal records. We have now completed our demonstration of walking you
through an example of submitting an organization application in PECOS.