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Video instructions and help with filling out and completing Who Form 8815 Enrolled

Instructions and Help about Who Form 8815 Enrolled

Hello and welcome to one of our Pecos demonstrations. In this demonstration, we will be walking you through one example of submitting an organization application in Pecos. The example I'll be showing you here today demonstrates a user submitting an application for a group clinic called Primary Health Clinic. So, if the organization you are submitting on behalf of is not a group clinic, please keep in mind that the steps for beginning and completing your application will be very similar to what we'll be showing here, and we'll have many of the same screens. In order to actually begin this application, we'll have to log into the Pecos homepage to obtain your login credentials. And to find other helpful information regarding Medicare and the application process, please visit the Pecos homepage. Now, I'm going to log in and begin the application process. Enter your user ID and password, then select the login button. First, you have to select the "My Enrollments" button located on the left-hand side of the screen. You'll then be able to select the "New Application" button located over here on the left. You'll then be brought to the applicant identification page. On this screen, you'll be shown your employer information as a label and any organizations that you have access to submit applications on behalf. The presenter selects the provider and then selects the next page button. On this screen, you will need to indicate the state in which the organization that you are submitting on behalf of provides healthcare services. In this example, Primary Health Clinic provides services in California, so that's what we'll select here. Presenter selects the state and selects next page. On this page, you are being prompted to indicate whether or not the organization you are submitting the enrollment for is the supplier of durable...