PECOS Database Audit Service a Huge Success

Rock-Pond Solutions added a PECOS database audit service to assist home infusion and DME providers determine their readiness for the CMS requirement that all ordering and referring physicians related to a Medicare claim be registered in the CMS PECOS database.  Although the deadline to be fully compliant was extended from the July 6, 2010 date, the service has proven extremely useful to those who have gone through the audit. 

According to one customer who utilized the service, “The real challenge here is being able to identify the physicians that are not registered who are associated with active patients.  Over time our physician file has grown to thousands of physicians and the Rock-Pond audit service enabled us to focus on the unregistered physicians that were involved with active Medicare patients.  We know our exposure, have adjusted our intake process to include PECOS registration verification and billing notification and we are ready when CMS decides to enforce compliance.” 

One customer who had us process their file today had the following stats.  We turned the file around in less than 10 minutes.  It doesn’t matter how cheap your clerical staff is, you can’t beat the price to quickly identify your exposure like this.  They had:

• 4,463 physicians
• 1,131 that were not in the PECOS database
• 3,332 that found a match in PECOS
• Of the 1,131 that were not there, it told them that only 30 had current active patients on census
• The report provides a drill-down “view patient” feature to quickly identify which ones have Medicare insurance
• Of the 3,332 that a match was found, 1,445 had differences in the first name and 192 had differences in the last name.

They have everything they need to put together a plan so when Medicare decides to enforce compliance, they are ready.  They went “from thousands of physicians, where do we start, I hope we are doing ok” to “we know exactly where we are and we can get this done” within 10 minutes.  We will do another batch comparison for them for free when compliance goes into effect. 

The  PECOS database audit service is a Rock-Pond Solution worth using whether you think you are in compliance or know you are not. It will check the name and PECOS status of ALL of your physicians at one time and tell you exactly where you stand.  Your results are delivered in an easy to use Excel Spreadsheet.

Featured Artist – Deborah Allen