The Why, Who and How to Setting up Authorized and Delegated Officials Using PECOS
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The Why, Who and How to Setting up Authorized and Delegated Officials Using PECOS

Sep 20, 2018
  • Author:
    Dawn Anderson, PESC, CPMSM
    Title:
    Senior Consultant
    Company:
    Former VerityStream Employee
    Dawn Anderson is an experienced health care management professional with over 20 years' experience including credentialing, privileging, revenue cycle management, managed care and provider enrollment. She is recognized nationally as an enterprise-wide process redesign expert. She has demonstrated an ability to synthesize workflows into a collective and focused vision endorsed by key stakeholders. She has directed initiatives with outcome-based solutions, interpreting workflows and facilitating integration into software.

Use of the PECOS system can create efficiencies for your organization and can help accelerate your enrollment process, decrease turn-around-times and increase your revenue by decreasing the amount of money at risk when new providers join your practice.


The Provider Enrollment, Chain, and Ownership System (PECOS) is the Centers for Medicare & Medicaid Services (CMS) online Medicare enrollment system where providers and suppliers can:

 

  • Submit Medicare enrollment applications
  • View and print enrollment information
  • Update enrollment information
  • Complete enrollment revalidation
  • Withdraw from the Medicare Program voluntarily
  • Track the status of a submitted Medicare enrollment application

 

The first things that needs to occur is the registration of your Authorized Official and Delegated Official(s) in the I&A System so they can electronically approve transactions like they physically sign paper applications today. The process is relatively straight-forward.


Background:


The Centers for Medicare and Medicaid Services (CMS) uses several systems for provider enrollment. The Identity & Access Management (I&A) System is the system where you will register your organization’s Authorized Official (AO), Designated Officials (DOs), Staff End User (SEU) and designate surrogates that will work on their behalf in these systems.


The Identity & Access Management (I&A) System allows you to:

 

  • Apply for and manage National Provider Identifiers (NPIs) in the National Plan and Provider Enumeration System (NPPES)
  • Use PECOS to enroll, update or revalidate information with Medicare
  • Register to receive Electronic Health Record (EHR) incentive payments

Who uses the system?


There are various types of users that work in the CMS systems, including PECOS, on an organization’s behalf. The type of user depends on the relationship and duties with the organization. You may designate users who can act on your behalf to manage connections and staff, including appointing and approving other authorized users in the PECOS system.


Today we will focus on designating, inviting and authorizing your Authorized Official (AO) and Delegated Officials (DOs) in the I&A system so they can approve the organization’s applications in PECOS.


It should be noted that since CMS recommends that you designate, invite and authenticate in the I&A system, the same AO and any (DOs) that you have identified as AO or DOs, respectively, on their enrollment in PECOS, this article is following that recommendation. They must be able to legally bind the company, are responsible for approving the staff within the system, and can be approved in the I&A System based on their status in PECOS.


Step One: Designate, Invite and Authenticate Authorized Official


To work on behalf of a provider or supplier organization in PECOS, the organization must designate, invite, and authenticate the Authorized Official as their AO.

Please note that the AO must meet the regulatory definition of “authorized official” as defined in the Medicare program.


The invited AO must respond to their employer’s invitation to be an AO or initiate the request themselves.


Step Two: Validation Completed


When validation is completed, if your organization has not established an account in the I&A System, the AO can establish one. If an I&A System account has been established, your organization may now submit enrollment applications in PECOS.


AOs will use this same process to invite DOs. AOs may appoint DOs to act on their behalf to approve and/or reject emails generated from the system.


When authenticated as an AO, you may use PECOS on behalf of the organization. You may also choose to delegate this responsibility to a (DO), Staff End User (SEU), or surrogate.


As an AO, you are responsible for approving requests submitted from system users to work on behalf of the organization in PECOS. You should check your email regularly and take action on requests or you may delegate this responsibility to a (DO).


It should be noted that only AOs can sign an initial enrollment application on behalf of an organization. A DO can sign changes, updates and revalidations.