CMS Interoperability & Standardization - Provider Enrollment (PECOS)
Investment ID: 009-000004611
Overview
Program Title
CMS Interoperability & Standardization - Provider Enrollment (PECOS)
Description
This investment funds a national repository of all Medicare provider and supplier enrollment data. PECOS retains all information furnished by providers and suppliers via the CMS 855, Medicare Provider/Supplier Enrollment Application.
Type of Program
Major IT Investments
Multi-Agency Category
Not Applicable
Associated Websites
http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/MedicareOrderingandReferring.html, http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/InternetbasedPECOS.html
Investment Detail
This Investment primarily focuses on enhancing and optimizing the Provider Enrollment, Chain and Ownership System (PECOS), by streamlining the enrollment process to reduce the Provider burden, providing consistent data to Medicare Fee for Service Systems, and allowing fraud investigators to have a complete national picture of a provider, its managers, and its owners.
The percentage of enrollments processed electronically (rather than on paper) increased by over 10%.
The following measures were taken to meet the SLOs
1. Implemented 237 stabilization defect fixes to improve system usability.
2. Reduced the average CRT ticket backlog in 2020 to 68, compared to 170 in 2019.
3. Resolved these user tickets much faster and were well within set SLO targets, meaning the users can complete the enrollment submission workflow quicker with fewer issues than in previous years.
4. Implemented 316 standalone Out of Release (OOR) requests to meet CMS policy, fraud prevention, audit reporting, and compliance reporting needs.
5. Implemented continuous process improvements and good quality assurance processes.
6. System defect density per Function Point Estimate (FPE) of 0.39 compared to the industry standard of 4.27.
7. Production defects per FPE of 0.007 compared to the industry standard of 0.32.
The percentage of enrollments processed electronically (rather than on paper) increased by over 10%.
The following measures were taken to meet the SLOs
1. Implemented 237 stabilization defect fixes to improve system usability.
2. Reduced the average CRT ticket backlog in 2020 to 68, compared to 170 in 2019.
3. Resolved these user tickets much faster and were well within set SLO targets, meaning the users can complete the enrollment submission workflow quicker with fewer issues than in previous years.
4. Implemented 316 standalone Out of Release (OOR) requests to meet CMS policy, fraud prevention, audit reporting, and compliance reporting needs.
5. Implemented continuous process improvements and good quality assurance processes.
6. System defect density per Function Point Estimate (FPE) of 0.39 compared to the industry standard of 4.27.
7. Production defects per FPE of 0.007 compared to the industry standard of 0.32.