April 13, 2007
May 23, 2007 Changes
Revised PACE NCPDP v5.1 Specifications pages were mailed to all providers the week of April 9, 2007. These revised specifications were also e-mailed to all known provider software vendors and claims submission networks.
Additional copies of these revisions are available upon request by contacting PACE Provider Services at 1-800-835-4080.
These revisions contain critical changes that MUST be implemented no later than May 23, 2007. Providers may implement these changes prior to May 23rd.
To prevent claims from denying on May 23, the following changes must be made:
Claims submitted to PACE/PACENET, CRDP, CF, SB, MSUD, PKU, SPBP, PAP or SWIF MUST contain the BIN of 002286. Some providers may currently be using the BIN of 400020 to submit claims to PACE and the other programs. This BIN must be changed to 002286 by May 23 to avoid denied claims. PLEASE contact your software vendor or switch if you are unsure about the BIN your system uses.
NOTE: The Program currently uses a PCN of 0000002286 for ALL Programs.
Claims submitted to CF, SB, MSUD, PKU, PAP and SWIF are to use the Processor Control Number (PCN) of ØØØØ6822Ø1. This change prevents incorrect claims data from being submitted to Medicare Part D.
No later than May 23rd claims submitted to PACE/PACENET, CRDP, CF, SB, MSUD, PKU, SPBP, PAP or SWIF must use the 10 digit NPI. The security code previously assigned to the Provider number is no longer required. Using the NPI requires the Service Provider ID Qualifier in Field 202-B2 to be changed to “01.”
Questions may be directed to Provider Services at 1-800-835-4080.