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Hello and welcome to one of our many PECOS demonstrations.
In this demonstration, we will be walking you through the process of submitting an application
in PECOS if you were a practitioner providing healthcare services and work in a group setting
like a private practice or a hospital. In order to begin this application, we'll
have to log in to the PECOS homepage. To obtain your login credentials and find
other helpful information regarding Medicare and the application process, please visit
the PECOS homepage. Please note that if you are a practitioner
working in the setting other than what we've just described or have some other business
arrangement, these steps for beginning your application are identical to what we'll be
showing here, and the process of enrolling will have many of the same screens shown in
this demonstration. After logging in, you'll need to select this
My Enrollments button here first. And because we're now creating a new application
for the practitioner Jenny Lewis you'll want to select this New Application button here.
After doing this, you will be prompted to answer a series of questions to help personalize
the application to your specific scenario. You'll first need to indicate who the application
is being created for. So here you'll select yourself and select
the Next Page button to continue. On this screen, you're being prompted to enter
whether or not you, as the practitioner solely order and refer services.
So for the purpose of this demonstration, I'm going to select no and continue.
On this screen, you will be selecting the business setting in which you work.
Because this demonstration is for a provider working in a group setting, we'll be selecting
the group member only field shown here. I'll go ahead and scroll down and select the
Next Page button to continue.
Here, you're identifying information will be displayed to you as a label so you can
go ahead and select the Next Page button now. You'll then need to indicate the state where
healthcare services are rendered. So for this example, the practitioner works
and provides services in Arizona so that's what we'll select and then move on by clicking
the Next Page button at the bottom of the screen.
And here you'll indicate your physician or non-physician specialty type.
So in this example, Jenny Lewis practices internal medicine so we'll select that from
the drop-down and then move forward with the Next Page button at the bottom of the screen.
You'll then be brought to a page which simply serves to inform you that the provider group
you work for must already be enrolled in Medicare. So please ensure that this is the case before
continuing your application. And if you'd like to continue, you'll just
select this Yes option here and move forward.
Finally, we've completed the initial set of questions for this enrollment and you can
then verify at the top of the screen that the information presented here is correct
for your situation. In this example, the practitioner is enrolling
indeed for the first time so you can scroll down to the bottom of the page after verifying
and start this initial enrollment by selecting that Start Application button shown here.
At this point in time, we're now ready to begin completing each of the sections needed
to submit the Medicare form. Before beginning the application, please note
some key features located at the top of the page.
First, there's a progress bar shown here which indicates how close you are to completing
your enrollment application and being able to scroll down to the bottom of the page and
selecting this Begin Submission button.
Additionally, there are three tabs located at the top of the page to help you in browsing.
First is the Topic View page which is the page we're on right now and conveniently gives
you high level view of what needs to be completed in your enrollment application by showing
check marks next to sections that are already done.
The Fast Track View on the second tab here shows all of these sections also within one
page including the information you've already entered easily accessible simply by selecting
this Go to Topic button here. And then lastly, there's the Error/Warning
Check tab which shows you what is still outstanding to be completed within your application and
any error the systems finds in what you've entered.
Note the red number shown here in the tab and that that will decreases you address each
item that's listed here as an error.
I'm now going to navigate by selecting this Topic View tab here.
There are number of sections that still need to be addressed and completed before I can
move forward by selecting this Begin Submission button.
These sections can be done in any order. And so for the purpose of this demonstration,
I'll start by walking you through the first section, the Personal Information section
and I'll do that by selecting this hyperlink now.
To complete this section, you'll need to start by selecting the Add Information button here.
You'll then see some personal identifying information shown as labels and you'll need
to complete the rest of the remaining required field shown here with the red asterisk.
I'll then select the Next Page button to continue. Here, you'll be able to provide any additional
names to Medicare like a former maiden name or professional name.
For the purpose of this demonstration, I'm going to select No, that there are no other
names that I'd like to report and click on the Next Page button at the bottom of the
screen. You'll then be able to enter any drug enforcement
agency or DEA numbers. And if you do not have this information, you
can move forward because it is optional by simply selecting the Next Page button.
You'll then indicate birth location information and I'll select Arizona and move forward.
[Next Page] On this page, you'll then be able to indicate the medical school or professional
school that you obtained your medical degree and then also be able to indicate the year
of graduation. After entering this information, you can select
Next Page button to move forward.
Finally, you'll be brought to the IRS Proprietary/Non-Profit Status page where you can indicate how the
business is registered with the IRS. In this example since we're enrolling as a
group member, I'm not going to enter this information as in here.
I'll just instead select the Save button to move forward.
You'll then be brought to this Topic Summary screen where you'll see all of the information
you entered here as a label, and if you need to make any updates at this time, you can
do so by selecting this Edit button here.
Since I'm satisfied with this information, I'm going to return to my topics by selecting
this Return to Topics button at the bottom of the screen.
As you can see, the Personal Information section now has a check mark next to it.
For the purpose of this demonstration, I'm going to go ahead and complete most of the
remaining sections missing in this enrollment application in order to show you the submission
piece of your enrollment in PECOS.
So now I've gone ahead and entered in almost all of the missing information needed in order
to scroll down to the button of the page and select this Begin Submission button shown
here. You'll see that if I scroll up here, there's
one section here that's still missing a check mark, the Required and/or Supporting Documentation
section and all the way at the top of the page, the Error/Warning Check tab still indicates
that there is one missing piece left to my enrollment application that needs to be addressed.
So I'll select this Error/Warning Check tab, and you'll see here that the error is that
an indication on the Required and/or Supporting Documentation needs to be made.
So we'll navigate directly to that section now by selecting this hyperlink here and you'll
then be pulled to enter this Required and/or Supporting Documentation section where you
can indicate whether or not you as the applicant wish to upload supporting documents to your
enrollment. So I'm going to select Yes that I want to
upload some documentation and I'll scroll down to the bottom of the page and you'll
see additional helpful information on the requirements for this documentation shown
here on the screen. And now, I'll go ahead and select one of these.
So for the purpose of this demonstration, I'll upload a Driver's License and then I'll
select the Upload button shown here. I'll then scroll down to the bottom of the
page and see that this document indeed has been uploaded and has been assigned the unique
Document ID shown here.
If you need to view that this information indeed was uploaded accurately, you can do
so using the View button. And if you need to remove this document because
you accidentally uploaded the wrong one, simply select this Remove button shown here.
You can go back and repeat the steps just shown to upload different documents instead
if you need to. Next, we'll navigate back to the error check
tab just to make sure that there are no errors left that I need to address before I can continue
with the application. And as you can see, there are no errors or
warnings found for this enrollment so I'll go ahead and select the Topic View button
now and I'll scroll down to the page and this Begin Submission button is now enabled.
So I'll go ahead and click on that now. The first page you are brought to in the submission
process is the Electronic Signature Option page where you will be given the opportunity
to electronically sign for any documents listed on the screen at this point in time.
So in this example, that includes the Certification Statement and Authorization Statement.
I'm going to select, Yes, that I would like to electronically sign these documents, and
what this means is that I would not then need to mail them and submit a hard copy to my
Medicare administrative contractor as this would be sufficient.
So I'll go ahead and select the Next Page button now.
The next piece of your submission process is the E-Signature Submission page where you'll
be prompted to review all documentation prior to E signing and then you'll need to scroll
down through the page and read each of the terms and conditions for all documents listed
here and agreed to accept them. And so in this example, I'll select Yes for
both the Certification Statement terms and conditions and the Authorization Statement.
If you continue to scroll down further to the middle of the page, you'll see the Signatories
for accepting a Reassignment section. Here, you'll need to identify an authorized
signer for the group that is receiving your reassignment of benefits.
So I'll select Tony Smith here from this drop down here as my authorized signer and I'll
enter Tony's e-mail address now. You're authorized signer will then receive
an e-mail suggesting that they need to go ahead and electronically sign that they accept
the reassignment of benefits indicated in this application before your Medicare administrative
contractor will be able to begin processing your enrollment record in PECOS.
And then if you scroll down further to the bottom of the page, you'll see this Complete
Your E-Signature section where you will need to indicate your identifying information and
this is what will validate and constitute as your electronic signature for your application.
And after entering this information here and verifying it for correctness, I'll select
this Next Page button to continue.
You'll then be brought to the Contact and Processing page where we'll go over to this
drop down here and select your Medicare administrative contractor and select the Apply button.
And as you scroll down on this page, you'll then see a reason for submission here as a
label. Other information on required and/or supporting
documentation and when you scroll all the way down to the bottom of the page, you'll
also see the document that you've uploaded to electronically submit with your application.
If at any point in time in navigating to this page there are any updates you need to make
to your application, you can still do so at this time by selecting the Previous Page button
here or selecting this Upload New/Remove Documentation hyperlink.
If you simply just want to review your document that you've uploaded and ensure that it is
indeed correct, you can do that without going back into your enrollment by simply selecting
this View button here. Because all of the information on the screen
seems accurate and I'm ready to submit my application to Medicare, I'll click on this
Complete Submission button now.
A pop up will then appear on your screen to notify you that any documentation that you've
not uploaded electronically with this application at this time will need to be printed and mailed
to your Medicare administrative contractor. And any delay in doing this will mean that
your application will risk not being processed in a timely manner by your contractor.
So, after you acknowledged this fact, you can select the OK button and then you'll be
brought to the Submission Confirmation page where you can print this as a receipt for
your personal records. Congratulations.
We've now just completed an initial submission to Medicare using PECOS.
And for any further information on the application process and Medicare itself, please visit
the PECOS homepage.