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Add esign Relocation Policy

Music Hello and welcome to PECOS. In this demonstration we will be showing you how to perform a change of information to the information in your Medicare Enrollment Application using PECOS. We will be showing you today how to do with this with an organization application but the steps for doing this, if you are an individual practitioner is very much the same and is also shown in our other demonstrations shown online. To do this you will have to log into PECOS using the same credentials that you used to submit your application the first time. If you have any questions on your logging credentials, you can use the Forgot Password or the Manage / Update User Profile hyperlink shown on the screen here. So now I will login and show you how to do this for an organization enrollment in PECOS. You are then going to need to select the My Enrollments button on the left-hand side of the screen and from here you'll see all the existing associates that you have the ability to submit applications on behalf of. Because I'm going to be showing you how to perform a change of information for our example as primary health clinic, I will select the View Enrollments button for this associate now. You are then navigated to this screen which will show you all of the enrollments that are existing for that organization. And, as you can see, I have one that is listed as approved here and then I have a new one which I began but have not yet completed or submitted to Medicare. So because I'm going to be performing a change to the existing application shown here that's approved, I'm going to need to select the More Options button here in order to do that. After selecting the More Options button, you'll be taken to a page where you will need to select what type of action you are trying to take on the Medicare Enrollment Application and because you need to make a change to your information, you'll select the Perform A Change of Information to Current Enrollment Information option. Please note that if there are any other activities that you need to perform over your Medicare application, like performing reassignment activities or updating EFT information, electronic funds transfer information, you can select those options here as well. We're going to click on the Next Page button to move forward. On this page you're being asked to indicate whether or not you are making updates to physical location information. For this change of information, I'm going to select No because the information I'm going to be updating is contact information and ownership information. But you can select Yes if this pertains to your specific enrollment scenario. On this screen you can indicate whether or not reassignment information is being updated and because I am not changing reassignment information, I'm going to select that other information is changing. On this screen you'll see a summary of what is being performed on your application in this scenario. You'll see here that it shows that the supplier is adding, deleting, or changing Medicare enrollment information. Since this is correct I'll scroll down to the bottom of the page here and click on the Start Application Button. Now we're navigated to the Fast Track View where you can see all the information you entered when you first submitted your application. If you'd like to view your information by the Topic View page, you can select the Topic View button at the top of the screen; the tab shown here and you'll be able to see all of your information that's completed with associated checkmarks next to them. Because I'm going to be updating ownership information, I'm going to select that topic and make my updates as necessary. So what I'm going to do is add another individual with ownership and primary health clinic so to do that I'll select the Add Information button. Note that if you actually just need to update information for previously entered individuals, you can do that as well. If you just go ahead and click the Edit button here or the Delete or Add buttons as well, if you have specific information to add. Now I need to enter all the information for the new individual I'm adding to this enrollment application. So the new individual with ownership interest in primary health clinic is a man by the name of Mark James. After entering all of Mark James information, I'll select the Next Page button at the bottom of the screen. Here you can indicate the country or state of birth if you have that information and if not you can select Next Page to move forward without doing so. And on this screen you'll need to indicate the type of relationship that this individual has to the organization on file. So because this new individual is another managing employee, I'll select Managing Employee and add the effective date of this also. And I'll scroll down to the bottom of the page and select the Next Page button to continue. Now I need to indicate whether this person that I'm adding is an authorized or delegated official or neither and because Mark James is neither authorized nor delegated official, I'll select this option and move forward. I'll now need to indicate whether or not Mark James has any final adverse actions associated with him. I'm going to select no for the purposes of this example but since I don't have any vital adverse actions to report for Mark James, I'm going to select the Save button at the bottom of the screen. And now as you'll see, I'm navigated to the topic summary page that shows Mark James added to our enrollment application, along with Jim Madison. Because I have no additional changes to make, I can move forward but if I made a mistake or need to update the information shown, I can do so with the buttons shown here. I'm going to now navigate back to the Error Check tab to make sure that I'm addressing every error still outstanding in the enrollment application before I attempt to submit. As you can see on the Error/Warning Check tab, there are no outstanding errors or warnings for this enrollment application. After resolving all errors and warnings for this enrollment application, you can navigate back to the Topic View screen and note it that any additional information that you'd like to update can be done now. Please note that multiple updates can be performed within the same change of information request. So again, in this example, because I've updated the individual control information, this conveniently enables me to combine all of my updates into one easy electronic submission using PECOS. When I'm ready to submit my application, and all of my changes have been made, you can scroll down to the bottom of the page here and you'll see the Begin Submission button which I'll select now because I'm ready to initiate the submission to my Medicare Administrative Contractor. Next you'll be prompted and shown the electronic signature page. This page will be displayed to give you the option to electronically sign all applicable documents for your submission. In this case, it's a certification statement. So please note that any documentation that you electronically sign will not need to be printed and manually mailed to your Medicare Administrative Contractor. So, for the purpose of this demonstration, because this is so convenient I'm going to select that yes, I do want to electronically sign my certification statement so I don't have to mail this in to my contractor for processing. I'll select the Next Page button to move forward. On this page you'll need to indicate who the authorized signer is for this update and I'm going to select Jim Madison from the dropdown as he is the authorized official. I'll select Apply and then I'll need to enter Jim Madison's email address. Jim Madison will be sent an email and contacted in order to electronically sign the changes that have been made in this enrollment application. After I'm done entering Jim Madison's contact information, his email address, I can select the Next Page button. I'm now navigated to the submission page which shows me my Medicare Administrative Contractor listed as a label and supporting documentation information shown in the center of the page here. Please read all of this information along with a reason for your submission to make sure that it is all accurate, before scrolling down to the bottom of the page and completing your submission. Upon scrolling down to the bottom of the page, you'll also see this current uploaded document section which shows all of the documentation that's been uploaded and associated to your Medicare enrollment. Because the CMS-460 Form is what was uploaded when I first submitted my Medicare enrollment, it will still show-up here as a note. You can view this document using the View button here and then you can complete the submission by selecting this option shown at the bottom of the screen. If in reviewing all of this information, you need to make any updates, you can still do so now by selecting the Previous Page button here. I'm ready to complete my submission so I'm going to move forward by selecting that button shown on the bottom of the screen. A pop-up will then appear on your screen, prompting you that any uploaded documentation that you included in your electronic enrollment has been submitted to your Medicare Administrative Contractor and any other required information will need to be mailed into your contractor and if you do not do so, you will risk your enrollment being delayed for processing. After acknowledging this fact, you can select Ok to move forward. You're then navigated to the Submission Confirmation page where you can print your receipt that you've submitted your change of information request. Congratulations, you've completed your change of information to your Medicare Enrollment Application.