Recently physicians have been receiving letters from their carriers stating that they do not have valid enrollment with that carrier. This is happening even though the physician appears on the Centers for Medicare and Medicaid Services (CMS) order/referring master list. The problem stems from the physician’s reassignment information not being updated. Provider transaction account numbers (PTAN) are often used for authentication purposes by your carrier, so make sure the PTAN is associated with the provider’s National Provider Identify (NPI).

Providers are advised by the Medical Group Management Association (MGMA) to use the internet-based Provider Enrollment, Chain, and Ownership System (PECOS) to determine the PTANs listed for the provider. However, locating PTANs on PECOS can be challenging. CMS does acknowledge that the PTAN is hard to find within PECOS and is working to fix the problem. 

ECP’s enrollment coordinators help our clients with proper provider enrollment challenges.

TIP

It’s a good practice to call your contractor to find out the PTANs associated with your NPI instead of using PECOS. Some contractors will require a written request.