Reimbursements

PACE programs are required by federal regulations to have a Provider Network to meet the needs of our participants. If you need another copy of our contract, please contact Rena Wright at (336) 550-4047 or rena.wright@pacetriad.org. To ensure accurate and timely payments please refer to Section 3, Compensation and Financial Provision of the contract.

Remember:

• PACE of the Triad reimburses in accordance with the Medicare or Medicaid fee schedule for services rendered to participants.
• PACE of the Triad must authorize all services to receive payment unless an emergency situation.
• All claims for payment must be submitted on either a UB-92, HCFA 1500 or other agreed upon invoice to Lutheran Services of the Carolinas, PO Box 669, Salisbury, NC 28145
• You may also submit electronically through using Payor ID TRIA01 no later than ninety (90) days after the date of service. Claims not submitted within the stated timeframe may not be eligible for payment.
• PACE of the Triad reimburses Providers for outstanding claims within thirty (30) days after receipt of Provider’s invoice, provided such invoice and other reports and clinical information reasonably required by us are submitted in a format acceptable to PACE of the Triad. If you have claims questions, contact Lutheran Services of the Carolinas at (704) 603-9251 or email: paceclaims@lscarolinas.net.
• Providers must accept payment by PACE of the Triad as payment in full for services and shall not solicit or accept any surety or guaranty of payment from any third party or the participant. Providers are not allowed to bill participants for any PACE approved service.
• Do not bill Medicare or Medicaid for any services provided to PACE of the Triad participants because the invoice will be denied. Remember PACE is the insurance plan and health care provider.