PECOS application signatures

The internet-based Provider Enrollment, Chain and Ownership System (PECOS) is a paperless process to submit provider enrollment applications. When completing your application online, do not submit your application until you have verified all sections are accurate, complete, and you are ready to sign.

Effective October 1, 2018, there are two ways you can submit your signature:

• Electronic signature

Once you've clicked "Begin Submission," you'll be taken to the "Signatory" selection for the enrollment. You will need to select the authorized signer from the drop down. On the next page, you choose "electronic signature."

Provide the email address for the authorized signer. PECOS will send an email to the email address provided with directions on how to finish the electronic signature.

• Upload your signature

When you get to the "Required and/or Supporting Documentation" section in PECOS, expand the list so that you can view all supporting documentation that may be required. Documentation for signatures will be toward the bottom of the list. View and print the signature documentation.

The authorized signer must print, sign and date the documentation. You must scan the pages into your computer so that you will be able to upload the documentation after you submit the application. The file must be saved as a PDF or TIFF. Once the application is ready to submit, click "Begin Submission". On the next page, you will have to select the authorized signer for this application. Select the upload button as signature method; at the bottom of this page, you will upload the signature(s) for this application.

If you need assistance completing your PECOS applications, please view the enrollment tutorials.