PACE
Provider
Bulletin
March 2, 2007
Important Information
PACE will
be conducting a PACE provider re-enrollment beginning in March. Pre-printed
documents containing current provider information accompanied by a new PACE
Provider Agreement will be mailed to all PACE providers.
ALL PROVIDERS SHOULD HAVE OR SHOULD BE
IN THE PROCESS OF ACQUIRING THEIR NATIONAL PROVIDER IDENTIFIER (NPI) NUMBER.
PACE WILL REQUIRE THE NPI NUMBER NO LATER THAN MAY 22, 2007.
Note: For
those providers who have already notified the Program of their NPI number, PACE
currently accepts this number as their provider number for claims processing. When
using the NPI number for claims submissions, the claim must have the Service Provider
ID Identifier changed from “99” to “01” in Field 202-B2.
Providers
who failed to bill Highmark Part D correctly have been sent detailed reports
and instructions on the re-billing procedure. These reports were sent to all
affected providers in a special mailing on Monday, February 26.
PACE will
review its pricing logic to insure that the Program is reimbursing the
difference between a Part D primary plan’s co-pay and the PACE co-pay.
PACENET
cardholders NOT enrolled in a Part D Partner plan are responsible for a PACENET
monthly premium of $28.45.
Questions may be directed to
Provider Services at
1-800-835-4080