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How to complete any CMS-855A Form online:
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Video instructions and help with filling out and completing Medicare change of ownership form
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 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 demonstration shown online to do this you will have to log into Pecos using the same credentials that you use to submit your application the first time if you have any questions on your login credentials you can use the forgot password or the manage slash update user profile hyperlinks shown on the screen here so now I will log in and show you how to do this for an organization presenter enters user ID and password you are then going to need to select the mine Homans button on the left hand side of the screen and from here you'll see all of 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's 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 we 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 page 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.