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 find other helpful information regarding Medicare and the application process please visit the Pecos home home page now I'm going to log in and begin the application process entering user ID and password selected 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 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 health care services in this example primary health clinic provide 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 medical equipment for the purpose of this demonstration we will be selecting know since primary health clinic is a group practice and does not provide such supplies we'll go ahead and select the next page button now you are brought to the primary Medicare services rendered page where you will need to specify what type of services the organization provides as we stated in the beginning of our demonstration primary health clinic is a clinic group practice so we'll go over here to the part beef supplier services section and locate that from the drop-down I'll go ahead and select the next page button now next you'll be brought to a screen that asks you if the organization you are submitting for is an Indian Health Service or IHS for this demonstration I'll select no and move forward now you are brought to the new group application screen this screen serves to inform you that in addition to the current application being completed each member of that organization must also enroll in Medicare and reassign their benefits after you can move forward by clicking on the next page button at the bottom of the screen so finally we've completed the initial set of questions for this enrollment and you can now verify on the screen before beginning the application that the information here is correct and accurate for your organization after verifying this information you can go ahead and click on the start application button at the bottom of the screen at this point in time we are now ready to begin completing each of the sections needed to submit the Medicare application form before beginning this application please note some key features located at the top of the page first we have the progress bar which shows you how close you are to completing your enrollment application additionally there are three tabs also located at the top of the page to help you in browsing the first is the topic view page which conveniently gives you a high-level view of all that needs to be completed and shows checkmarks next to the sections that are already done the fast-track view shows all of these sections within one page as well including the information already entered lastly there's the error slash warning check tab which shows you what is still outstanding to be completed within your application and any errors the system finds in what you've entered note that the red number shown in the tab will decrease as you address each item listed on that tab to begin the application we'll go ahead and select this organization information hyperlink and will now have to select the add information button to begin our data entry on this page we'll see the legal business name and tax identification number of our organization shown as a label and other fields ready and accessible for data entry such as the effective date of 10 which I'll go ahead and enter now next you'll be taken to the IRS proprietary slash nonprofit status page for the sake of this example we're going to select that primary health clinic is a proprietary business and we'll hit the next page button to move forward next you are brought to the organization structure page where you will need to enter the type of organization structure for the organization rolling in Medicare because primary health clinic is a partnership I'm going to navigate over to this drop-down select partnership and move forward by hitting save you are now navigated to the topics summary screen for organization information and you can see all of the information that was just entered on the previous screens here as a label if you need to edit any of this information go ahead and click the edit button here if not you can move forward by selecting the go-to error check button or the return to fast-track button below presenter selects that return to fast-track button I'm now going to navigate back to the topic view by selecting the topic View tab at the top of the screen and you will notice that the organization information section now