New NPI Verification Process through PECOS
There has been an important update from the Centers for Medicare and Medicaid Services (CMS).
CMS has notified ABILITY that as of April 1, 2019 mainframe eligibility applications hosted in Direct Data Entry/Fiscal Intermediary Standard System (DDE/FISS) and Common Working File (CWF) will be undergoing a process change. Users attempting to verify Part A Medicare eligibility benefits will be required to use a National Provider Identifier (NPI) that is registered in the Medicare Provider Enrollment and Chain/Ownership System (PECOS) database. As part of the eligibility process, these eligibility applications will now verify that the NPI used on the inquiry is present in the Medicare PECOS database.