IMPORTANT INFORMATION FOR PACE PROVIDERS

October  6, 2006

 

PACE/PACENET Part D List

 

 

·        PACE has enrolled over 150,000 cardholders in the Program’s seven (7) selected Medicare Part D Prescription Plans.  

 

·        PACE is providing this cumulative list of all cardholders currently enrolled in the selected Medicare Part D plans who frequent your pharmacy. This enclosed list contains the PACE cardholder’s name, PACE card number, the Medicare Part D insurer’s name, BIN, PCN, Group name/number and the cardholder’s ID number.

 

·       PACE cardholders are continually enrolling in Part D plans; therefore, this list can not be all inclusive. Providers should continue to inquire if a PACE/PACENET cardholder has a Medicare Part D card.

 

·       IMPORTANT: In the event a cardholder dis-enrolls from a PACE partner plan resulting in the claim being denied for “non-matched cardholder ID” (NCPDP 52) or “Filled After Coverage Terminated” (NCPDP 69), the claim can be submitted to PACE with:

o      an OCC of 3,

o      the plan’s deny code and

o      the BIN of the plan listed on the PACE file.

PACE will honor the claim during the time that the Program’s other coverage record does not contain the most current eligibility data from the partner plan.

 

Questions may be directed to Provider Services at

 1-800-835-4080.