PACE

PROVIDER BULLETIN

August 13, 2004

Program Updates

Effective Tuesday, August 17, 2004:

Submission time limits for PACE/PACENET claims revert to 90 days from the date of service. Providers no longer have to use the B-3 Transaction to rebill claims older than 30 days from the date of service.

The PACENET deductible begins accruing based on the date of service of the first claim submitted. Previously, the deductible began accruing on the date of PACENET enrollment. Note: Current PACENET cardholders with approved PACENET claims will be unaffected by this modification.

Approved PACE claims whose Program reimbursement calculation equals $0.00 will have the lower of either the other payer’s copay or the PACE copay returned in the response. Providers whose claims previously denied for NCPDP Error “DU- Total price Invalid,” because of the copay disparity will have these claims accepted into PACE claim’s history although no payment will be received from PACE.

Questions may be directed to PACE Provider Services at

1-800-835-4080.

PPB-04-013