IMPORTANT INFORMATION FOR PACE PROVIDERS

Serving PACE Cardholders with MDP Cards.

 

July, 2005

 

 

 

·        Most PACE Cardholders have enrolled in First Health’s Medicare Discount Program. For these cardholders, if a claim denies for failure to bill the primary carrier (NCPDP edit 41), PACE providers can call Provider Services to find out the First Health MDP number in the event the cardholder is unavailable or forgot his/her card.

 

 

·        Some MDP carriers have identified their MDP members for PACE. Providers attempting to bill PACE as the primary insurer for prescriptions for these cardholders are having these claims denied.  Providers then must rebill PACE after finding out from the cardholder their MDP number.

 

 

·        To help providers bill correctly the first time, PACE is providing a  list of cardholders who frequent your pharmacy. This enclosed list contains both the name of the PACE cardholder and the MDP insurer as well as their PACE card number. Although the Program is unable to furnish the other MDP card number, we hope that this information will enable providers to find out this information to be able to bill PACE as the secondary payer.

 

Questions may be directed to Provider Services at

 1-800-835-4080.

 

 

 

 

                                                                          PPB-05-016