Lisa,
We had a similar issue with one of our physicians. Fortunately, we just learned that the claims in the period in question were paid retroactively following reestablishment of his PECOS status.
We also found it impossible to get a clear answer from CMS ahead of those claim determinations. I hope your experience matches ours.
Scott Freeman, MD, HMDC, FAAHPM
Medical Director
Northwell Hospice
Assistant Professor of Medicine
Zucker School of Medicine at Hofstra/Northwell
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Original Message:
Sent: 3/25/2026 9:25:00 AM
From: Lisa Reichert
Subject: Medical Director PECOS enrollment inactivated
One of our hospice claims denied due to the Medical Director not being enrolled in PECOS on the benefit period listed. I've determined that his enrollment ended around 2/23 (he is trying to find that out and working with Medicare to fix it (it was Medicare's error). We're not sure if it will be backdated or not at this time. They told him it could take up to 45 days to get straightened out.) If we have our physician designee sign all the certifications/recerts today, are we able to bill for the days between Feb 23 & 3/24? I've received multiple answers from different NGS Provider Enrollment and Claims reps.
I appreciate any assistance you can provide!
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Lisa Reichert
Calumet County HHC/Hospice Agency
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