The PEPPER Team is committed to ensuring and maintaining the confidentiality
of each provider’s PEPPER.
Likewise, all recipients of PEPPER are expected to maintain and safeguard the confidentiality
of privileged data or information.
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Undefined
Please enter your 6-digit CMS Certification Number
(also referred to as provider number or PTAN).
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Enter either a Patient Control Number *or* a Medical Record Number (found at form locators 03a or 03b
on the UB04 claim form) from a claim of a traditional fee-for-service Medicare beneficiary who received
services during the specified time period (“from” or “through” date between July 1-Sep. 30, 2019 for providers
except HHAs and PHPs; between Oct. 1-Dec. 31, 2019 for HHAs and PHPs).
Depending on your provider type, you will need to enter one of the following two types of information:
- A validation code, which is emailed to your facility contact (i.e., your security administrator or Provider Enrollment,
Chain, and Ownership System [PECOS] contact)
- Either a patient control number or a medical record number (found at form locators 03a or 03b on the UB-04 claim form)
from a claim of a traditional Medicare Fee-for-Service beneficiary who received services during the specified time period.
For detailed instructions, please click here.
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Need help finding your Validation Code?
Check the tips shown to the left.
If you need more help, detailed instructions
are on the PEPPER Distribution page.
Open the PEPPER Distribution page
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of this health care provider and further certify that I have the actual authority
to
receive PEPPER and all other confidential information concerning this health care
provider.
If a provider does not have a management position with any of these titles, the person who has the authority to make decisions on behalf of the organization should check the box for the title that best describes their position.
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