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