PACE

PROVIDER BULLETIN

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:

 

BIN

 

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.

 

PCN

 

NOTE: The Program currently uses a PCN of 0000002286 for ALL Programs.

 

No later than May 23rd, claims submitted to PACE, CRDP SPBP1 and SPBP 2 must be changed to Processor Control Number (PCN) of 0000102286. This change ensures that cardholder amounts are accurately recorded for Medicare Part D.

 

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.

 

NPI

 

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.