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The web site tells women how to make an appointment. They will still need an order from their doctor to get the procedure. There must be someone to whom the report will be sent and who will be responsible for discussing the results with the patient.
I see no one has answered this question, which gets to the heart of what PP does by providing referral for mammograms. PP gets the report and takes responsibilty for making sure there is appropriate follow up.
Eighty percent of PP clients are there for contraceptive services. Screening for STDs, pap smears, and mammogram referrals in the at risk population are part of that. Unless they serve a significant number of clients with Medicare, there would be no reason to become a Medicare provider. There is nothing that would prevent a PP physician from enrolling as a Medicare provider if desired, though.
The over age 65 group is not part of that contraceptive-seeking demographic, and with Medicare the option exists to see a private gynecologist. That's the same reason many with commercial insurance see private doctors rather than using PP. However, nothing prevents someone with commercial insurance from using it at PP if PP is a provider for their plan.
Here's one PP's insurance plans, including Medicare and Medicaid:
Every physician determines which insurance plans he wishes to accept, including Medicare.
By the way, Medicare providers do not "enroll in PECOS". PECOS is just a web portal. It can be used to credential with Medicare, but PECOS is not Medicare and has nothing to do with the credentialing itself, which is done through local third party contractors that do administer Medicare benefits. It is not required to use PECOS. Paper applications can still be submitted.
"The Internet-based Provider Enrollment, Chain and Ownership System (Internet-based PECOS) can be used in lieu of the Medicare enrollment application (i.e., paper CMS-855)..."
"Mail your completed application and all supporting documentation to the Medicare fee-for-service contractor (also referred to as a carrier, fiscal intermediary, Medicare Administrative Contractor, or the National Supplier Clearinghouse) serving your State or geographic location."
The majority of doctors will use PECOS because it is more convenient.
If a doctor wants to order any tests, they are required to be enrolled with PECOS. So if you want to order any lab, radiology, etc. you have to be in the PECOS system. If you are doctor that doesn't do a single test, then you should shutter your practice immediately.
The argument in the thread was that the government can't limit payments, and as shown, they currently do.
It's silly for people to fight so hard for PP. Even if you close your eyes and pretend the videos don't exist, they've had to pay back the federal government for Medicaid fraud. There is no reason to keep sending federal funds to PP when there are so many more good options available.
If a doctor wants to order any tests, they are required to be enrolled with PECOS. So if you want to order any lab, radiology, etc. you have to be in the PECOS system. If you are doctor that doesn't do a single test, then you should shutter your practice immediately.
The argument in the thread was that the government can't limit payments, and as shown, they currently do.
It's silly for people to fight so hard for PP. Even if you close your eyes and pretend the videos don't exist, they've had to pay back the federal government for Medicaid fraud. There is no reason to keep sending federal funds to PP when there are so many more good options available.
There is a medicare fraud settlement with a particular PP operation in, I believe, Houston. There is no broad problem with PP and likely the parent organization had little role in the particular settlement. It was actually a whistle blower action where someone inside PP knew a thing that the particualar PP was doing did not meet federal requirements. She got 1.2 million for her efforts. My personal interist had a similar problem when her practice got crossways with the Feds over a test they ordered and did in house. There was nothing wrong with the test or ordering it - but they got into trouble over doing a test they ordered in house. They finally settled with government for a few tens of thousands.
If a doctor wants to order any tests, they are required to be enrolled with PECOS. So if you want to order any lab, radiology, etc. you have to be in the PECOS system. If you are doctor that doesn't do a single test, then you should shutter your practice immediately.
The argument in the thread was that the government can't limit payments, and as shown, they currently do.
It's silly for people to fight so hard for PP. Even if you close your eyes and pretend the videos don't exist, they've had to pay back the federal government for Medicaid fraud. There is no reason to keep sending federal funds to PP when there are so many more good options available.
No orders involve PECOS. PECOS is merely a web portal to Medicare. Any doctor who is credentialed with Medicare, whether through PECOS or by using a paper application mailed to the third party contractor that administers Medicare benefits in his area can order tests and bill for services for Medicare patients. Most Medicare providers will use PECOS because it is more convenient than filling out and mailing an application to participate with Medicare, but it is not required to do so.
You do not enroll with PECOS, you just use it to enroll with Medicare.
No orders involve PECOS. PECOS is merely a web portal to Medicare. Any doctor who is credentialed with Medicare, whether through PECOS or by using a paper application mailed to the third party contractor that administers Medicare benefits in his area can order tests and bill for services for Medicare patients. Most Medicare providers will use PECOS because it is more convenient than filling out and mailing an application to participate with Medicare, but it is not required to do so.
You do not enroll with PECOS, you just use it to enroll with Medicare.
We are dragging this thread off topic, so this is the last time I'll go back and forth on this.
Starting the beginning of 2014, Medicare required physicians who treat Medicare patients to be registered with PECOS. If the physician was not enrolled, Medicare claims for tests, services, etc are denied.
It's part of the ACA.
I work in healthcare consulting. This is something I deal with every day.
ETA: You know what's funny? I was just googling to find a link for people who aren't familiar with PECOS and almost every link talks about physicians being "enrolled in PECOS". You can tell who does this every day. Anyone who wants to read the information on PECOS can search PECOS, January 2014.
Poor people go to the ER for healthcare, with or without Medicaid.
Isn't that something we, as a nation, don't want, since it costs so much more at the ER?
You guys are showing your true colors. You really don't care about heath care costs. Your objective is to limited access to legal abortions.
We are dragging this thread off topic, so this is the last time I'll go back and forth on this.
Starting the beginning of 2014, Medicare required physicians who treat Medicare patients to be registered with PECOS. If the physician was not enrolled, Medicare claims for tests, services, etc are denied.
It's part of the ACA.
I work in healthcare consulting. This is something I deal with every day.
ETA: You know what's funny? I was just googling to find a link for people who aren't familiar with PECOS and almost every link talks about physicians being "enrolled in PECOS". You can tell who does this every day. Anyone who wants to read the information on PECOS can search PECOS, January 2014.
"You can apply for enrollment in the Medicare Program, revalidate your enrollment, or
change your enrollment information by using either:
• PECOS, located at https://pecos.cms.hhs.gov/pecos/login.do on the Internet; or
• The paper enrollment application, Form CMS-855I (and, if appropriate, Form
CMS-855R), located at https://www.cms.gov/Medicare/CMS-For...orms-List.html
on the Centers for Medicare & Medicaid Services (CMS) website."
"We encourage you to use PECOS instead of the paper Medicare enrollment application.
Advantages of using PECOS include:
• Completely paperless process including electronic signature and digital
document feature;
• Faster than paper-based enrollment;
• Tailored application process means you supply only information relevant to your
application and specialty;
• More control over your enrollment information, including reassignments;
• Easy to check and update your information for accuracy; and
• Less staff time and administrative costs to complete and submit enrollment to Medicare."
Once enrolled with Medicare via PECOS or by paper application, the info can be accessed via PECOS.
You seem to have the idea that a provider must use PECOS to enroll. That is not true.
PECOS does not determine whether a provider can provide Medicare services or order tests or make referrals for Medicare patients. In order to that, the provider has to be enrolled with Medicare as a provider. In fact, in some situations where the provider will not be billing for patient care it is possible to enroll with Medicare just to order tests and make referrals. PECOS is just a web portal to access that information, no more, no less.
PECOS is certainly going to have nothing to do with limiting payment for Medicare patients to PP or to any physician, which is what you initially claimed. Medicare will credential any physician who applies to enroll (through PECOS or by paper) who meets Medicare standards for enrollment. That applies to those who work at PP in the same way it applies to physicians who work anywhere else.
"You can apply for enrollment in the Medicare Program, revalidate your enrollment, or
change your enrollment information by using either:
• PECOS, located at https://pecos.cms.hhs.gov/pecos/login.do on the Internet; or
• The paper enrollment application, Form CMS-855I (and, if appropriate, Form
CMS-855R), located at https://www.cms.gov/Medicare/CMS-For...orms-List.html
on the Centers for Medicare & Medicaid Services (CMS) website."
"We encourage you to use PECOS instead of the paper Medicare enrollment application.
Advantages of using PECOS include:
• Completely paperless process including electronic signature and digital
document feature;
• Faster than paper-based enrollment;
• Tailored application process means you supply only information relevant to your
application and specialty;
• More control over your enrollment information, including reassignments;
• Easy to check and update your information for accuracy; and
• Less staff time and administrative costs to complete and submit enrollment to Medicare."
Once enrolled with Medicare via PECOS or by paper application, the info can be accessed via PECOS.
You seem to have the idea that a provider must use PECOS to enroll. That is not true.
PECOS does not determine whether a provider can provide Medicare services or order tests or make referrals for Medicare patients. In order to that, the provider has to be enrolled with Medicare as a provider. In fact, in some situations where the provider will not be billing for patient care it is possible to enroll with Medicare just to order tests and make referrals. PECOS is just a web portal to access that information, no more, no less.
PECOS is certainly going to have nothing to do with limiting payment for Medicare patients to PP or to any physician, which is what you initially claimed. Medicare will credential any physician who applies to enroll (through PECOS or by paper) who meets Medicare standards for enrollment. That applies to those who work at PP in the same way it applies to physicians who work anywhere else.
I know I said I wouldn't respond again, but you seriously have NO CLUE what you are talking about. You are trying to read and understand one link on the internet, and obviously it is over your head.
Do you believe Centers for Medicare and Medicaid?
Quote:
The Ordering and Referring files are displayed using the National Provider Identifier (NPI) and legal name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is legally eligible to order and refer Part B (clinical laboratory and imaging), DME and HHA claims, in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS).
That's a lot of jargon, but for layperson, it says you can't order any tests or services without having "enrollment records in PECOS."
This link is easier to read. From the American College of Radiology:
Quote:
CMS to Implement PECOS Phase 2 Edits in 2014
Effective January 6, 2014, the Centers for Medicare and Medicaid Services (CMS) will implement the Provider Enrollment Chain and Ownership System (PECOS) phase 2 edits. This edit requires that a valid National Provider Identifier (NPI) of the ordering or referring health care provider enrolled in CMS’ Medicare PECOS be listed on the claim. If the ordering provider is not enrolled, CMS will deny all claims including the imaging services ordered by the non-enrolled physician.
Look, there's that enrolled word again. Didn't you say that was the wrong term to use? Better get busy calling the American College or Radiology and telling them and every other medical group they are wrong. And let them know they are wrong about Medicare denying all claims too.
I could do this all day. I'm guessing you've never heard of PECOS before today.
PP itself is limited. Nationwide, there are many more public health clinics that provide women's health services, mostly located in low-income areas, than there are PP facilities.
PP is redundant and unnecessary for at least 2 reasons:
1) Public health clinics already provide women's health services.
2) we have Obamacare now, which covers women's health services.
You are mistaken. As has already been stated in this thread, many of the clinics on the link that YOU offered do not provide women's health services. And when I lived in Nevada the only 'free clinic' in Reno Nevada that provided women's health services (besides PP) had lines around the block every morning, they would take the first 50 patients and send the rest home.
As far as "Obamacare", women who do not have children, are not elderly or disabled and make less than $14,670 are not eligible for Obamacare, if they are in one of the 22 states that did not expand medicaid they have NO options for health care other than the ER or a free clinic (if they can find one)
In thought the ACA would cover all these poor people. Seems redundant.
They aren't covered in the 22 states that decided not to expand medicaid
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