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Notice to WSUPG providers regarding CMS reimbursement


05.05.2014

In the continued scrutiny to prevent fraudulent activity, The Centers for Medicare and Medicaid (CMS) has modified its processes for enrollment, revalidation and continued reimbursement to include direct practitioner involvement in the management of accounts. 

WSUPG can be named as a surrogate for each provider, but doing so will require initial minimal practitioner involvement.

In order to keep reimbursements coming in without interruption, and to make the process as seamless as possible, each provider will recieve an email with the following documents for review and action:

  1. CA Tutorial – overview of how to obtain surrogacy authorization
  2. PECOS & I Profile – blank profile for completion and signature

Once WSUPG has been identified as a surrogate, we will be able to continue to process Medicare enrollment and maintain Provider Enrollment Chain and Ownership System (PECOS), Medicare-based EHR, and National Plan & Provider Enumeration System (NPPES), on behalf of the provider.

Cooperation from existing WSUPG providers within the CMS system is needed as follows:

  • Provide National Plan & Provider Enumeration System (NPPES) NPI user name and password.
  • If you do not have the NPI user name and password, we will be able to create one for you, but the Medicare PECOS Profile will need to be reviewed, modified and returned to Marlene Mulrenin within five (5) days by faxing to 248-581-5640.
  • During this process, CMS will send you email (s) asking for your approval of requested surrogacy to WSUPG which will not require you to take any action. WSUPG will be able to perform all actions on your behalf after the return of the signed Medicare PECOS Profile granting authority to act on your behalf.
  • The preferred email address that is being requested on the Medicare PECOS Profile will be used for communication directly between yourself and CMS after the surrogacy process has been completed, should they wish to contact you.
  • Once WSUPG has completed all steps required to grant us surrogacy, your user name and password to access PECOS, EHR, and NPPES will be sent to you using the email address you provide.  Please note, the password we return to you will expire after 30 days. After this period you will need to reset your password the next time you wish to access these products.
  • As CMS has placed very stringent timelines around the completion of this process, please return the reviewed, modified/populated, and executed Medicare PECOS Profile within five (5) days so WSUPG can process the request through CMS without interruption to your Medicare reimbursement.

Thank you very much for your time and attention to this matter. Your cooperation is greatly appreciated.

For more information please contact Marlene Mulrenin at 248-581-5969 or mmulreni@med.wayne.edu.



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