How to Give Your Credentialer Access to Your Medicare Enrollment

Your credentialer handles your Medicare enrollment application, but there are two steps only you can do: giving them access to your account, and signing the application when it's ready. This guide walks through both.

Before You Start

PECOS (Provider Enrollment, Chain, and Ownership System) is what Medicare uses to manage provider enrollment. Your credentialer needs access to your PECOS account to submit and manage enrollment applications on your behalf.

Your PECOS access is managed through a separate login system called the CMS Identity & Access (I&A) system. If you set up your own NPI through NPPES, you already have an I&A account — it's the same login.

If someone else set up your NPI (a former biller, group practice admin, etc.), they may control the I&A account. Talk to your credentialer about how to get control back — the process depends on whether it was set up as an individual or organizational provider.

Expect to reset your password. If you haven't logged in for a while, the system will ask you to change your password before you can do anything else. The password rules are strict: 8-12 characters, at least one letter, one number, one special character, can't start with a number, and only certain special characters are accepted. Use a password manager and you may need a few tries to find a combination the system accepts.

Step 1: Give Your Credentialer Access to Your PECOS Account

You're authorizing your credentialer to view and update your Medicare enrollment application. This does not give them the ability to sign anything or legally represent you.

If you have a company (LLC, PLLC, group practice): access has to be granted to both your company's organizational profile and your individual provider profile. That's two separate connections, one for each, so expect to do this twice.

There are two ways to set this up. Usually your credentialer sends you the request and you approve it, so that's the one to expect.

The Usual Way: They Send the Request, You Approve It

This is the more reliable path and the one to expect in most cases. Your credentialer sends the request from their side, and you approve it. Here's what to do once they tell you it's been sent:

1. Log into the CMS Identity & Access system
2. On the Home tab, look for My Pending Connections
3. Check the boxes next to PECOS and NPPES for the request
4. Click Approve All Selected
5. If you have a company, approve the second request for your organizational profile the same way

Important: CMS doesn't reliably send a notification email when a request is pending, so don't wait for one to show up. Your credentialer will tell you when to check. Requests that aren't approved within 30 days are automatically rejected, so don't put this off.

The Other Way: Add Them Yourself

Sometimes your credentialer will have you set it up from your side. There are two ways to do this, and they'll tell you which one they need.

Add them as staff (gives one person access). This is the more reliable of the two, since it's an email invite with nothing to search for:

1. Log into the CMS Identity & Access system
2. Click the My Staff tab, then Add Staff
3. Enter their name and email
4. Set the role they ask for, usually Access Manager, which lets them manage your enrollment on your behalf (a Staff End User is more limited)
5. Submit, and they'll accept the invite from their end

Add their company as a surrogate (gives their whole team access). Use this when your credentialer works as a company with its own staff:

1. Log into the CMS Identity & Access system
2. Click the My Connections tab
3. Click the + icon next to your name or NPI to expand it
4. Click Add Surrogate (CMS's term for an authorized third party)
5. In Organization Name, enter your credentialer's company name (or their NPI if they have one), click Search, and select them
6. Check PECOS and NPPES
7. Click Submit, then click Done on the review page

Their company is searchable by its name even if it doesn't have an NPI. If you still can't find them, ask them to send you a request to approve instead. If you have a company of your own, repeat whichever method you used for your organizational profile too.

Step 2: Sign Your Application When It's Ready

Once your credentialer has prepared your Medicare enrollment application in PECOS, you'll need to sign it electronically. You'll receive an email from CMS when the application reaches the signature step. This often happens before your credentialer has had a chance to tell you themselves, so don't be surprised if it shows up in your inbox.

What to expect:

1. You'll receive an email letting you know a signature is needed
2. Log into PECOS using your I&A credentials (same login as NPPES)
3. Navigate to My Associates, then find the enrollment and click View Enrollments
4. On the Manage Signatures screen, select Electronic and enter your email address
5. Review and agree to the Terms and Conditions by checking both boxes — this completes your electronic signature
6. You'll see a confirmation that your application has been successfully submitted

Your credentialer can walk you through this step when it comes up if you need help.

You may need to sign more than once. If there are any issues with the application or corrections that need to be made after submission, each revision requires a new signature. This is normal.

Electronic vs. paper signatures: You can sign on paper, but electronic signatures are strongly recommended. Paper signatures frequently get delayed in the system and can hold up your enrollment. Electronic signatures are processed immediately.

Common Questions

What is PECOS?

PECOS (Provider Enrollment, Chain, and Ownership System) is the online system Medicare uses to manage provider enrollment. It's where your Medicare enrollment application lives.

Do I need an account if I already have an NPI?

Yes, but you probably already have one. Your NPI was created through NPPES, which uses the same login system (I&A). Try logging in at nppes.cms.hhs.gov with the credentials you used when you applied for your NPI.

How long does this take?

Usually your credentialer sends you the request, and the access is active within minutes of you approving it, so it mostly comes down to when you log in. Adding them yourself takes a few minutes either way.

Can my office manager do this for me?

It depends on their role on your record, and the title "office manager" doesn't tell you which one they have. An Authorized Official can do all of it. An Access Manager can do most of it but can't grant someone the Access Manager role (only an Authorized Official can). A Staff End User can't grant access at all. So check their actual role first, and if it's Staff End User, this step falls to you or to whoever holds Authorized Official on your record.

What does this access let them do?

View and update your Medicare enrollment application. It does not allow them to sign applications, legally represent you, or make changes to your NPI record without your knowledge.

Can I just give my credentialer my login instead?

CMS's login page states that sharing login information is prohibited, so this isn't recommended. Your account also uses multi-factor authentication, which means you'd need to be available to provide verification codes while they're logged in. Since you'll need to log in yourself later to sign your application anyway, it's better to grant access through the surrogate process above.

I have a company. Do they need access to both?

Yes. If you have an LLC, PLLC, or group practice with its own NPI, your credentialer needs access to both the organizational profile and your individual provider profile. They're managed separately in PECOS.

New to credentialing? Start with our getting started guide to make sure your setup is complete.

Need help with Medicare enrollment? Contact me and I'll walk you through the process.