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EIS 2500 – PROGRAM OF ALL INCLUSIVE CARE FOR THE ELDERLY (PACE)



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to make the case PACE by entering all appropriate PACE codes and select the new PACE provider using the PACE Authorization Screen.

      Brunswick, New Hanover, Alamance, Caswell, Orange, Durham, Catawba, Lincoln Caldwell and Alexander, Davidson, Davie, Iredell, Rowan, Cumberland, Moore, Robeson, Hoke, Harnett, Guilford, and Rockingham counties are participating in PACE. Current PACE providers are: Elderhaus, Inc. Piedmont Health SeniorCare, Pace at Home, Carolina SeniorCare, LIFE St. Joseph of the Pines, and PACE of the Triad.

      Individuals requesting PACE enrollment information should be referred to one of these facilities at the following addresses:

      Piedmont Health SeniorCare

      Providing All-Inclusive Care for the Elderly

      1214 Vaughn Road

      Burlington, NC 27217

      phone: 336-532-0000

      fax: 336-532-0001

      (Serving: Alamance and Caswell Counties)

      Elderhaus PACE

      The Alpher Center

      1950 Amphitheater Drive

      Wilmington NC 28401

      (910) 343-8209

      (Serving: Brunswick and New Hanover Counties)

      Life St. Joseph of the Pines, Inc.

      100 Gossman Drive

      Ste B

      Southern Pines, NC 28387

      (910) 246-3105

      (Serving: Cumberland, Moore, Robeson, Hoke, and Harnett Counties)

      PACE of the Triad

      1471 E. Cone Blvd

      Greensboro, NC 27405

      (336) 550-4040

      (Serving: Guilford and Rockingham Counties)

      PACE at Home

      1915 Fairgrove Church Rd.

      Southeast

      Newton, NC 28658

      (828)-468-3980

      (Serving: Catawba, Lincoln, Caldwell and Alexander Counties)

    REVISED 10/01/12 – CHANGE NO. 01-13

    XIII. (CONT’D)

      Carolina SeniorCare

      803 East Center St.

      Lexington, NC 27292

      (336) 746-3500

      (Servicing Davidson, Davie, Iredell and Rowan Counties)

      The PACE providers are responsible for enrolling individuals in the PACE program and referring them to the local DSS to determine Medicaid eligibility. Upon receipt of the referral from the PACE provider, DSS will complete a Medicaid eligibility determination and, if eligible, authorize the PACE payment in the EIS system.

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    XIV. PACE PATIENT MONTHLY LIABILITY (PML)

      All PACE recipients will have a Patient Monthly Liability (PML), even if the amount is zero. DMA makes a prospective monthly payment to the PACE organization of a capitation amount for each eligible participant. Therefore, if the PML must be changed, it must be changed for a future month on the DSS-8125 as it cannot be decreased using the P Screen.

      Contact the Division of Medical Assistance, Medicaid Eligibility Unit, at (919) 855-4000 when a correction is needed on a PACE case.

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    XV. PACE CORRECTIONS

      Contact the Division of Medical Assistance, Medicaid Eligibility Unit, at (919) 855-4000 when a correction is needed on a PACE case.

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    XVI. PACE REPORTS

      A. PACE Enrolled Recipients Report

        A report of PACE recipients in XPTR is titled DHRWBD PACE ENROLLED RECIPIENTS. This report is kept in XPTR for 365 days. It is run once per month on pull night and is sorted by county and district number and displays the following information:

        1. PACE recipient name
        2. PACE recipient ID number
        3. EIS case ID number
        4. County name and number
        5. District number
        6. PACE agency providing services

    REISSUED 10/01/12 – CHANGE NO. 01-13

      B. 5016 Forms Printed Report

        A list of 5016 forms printed daily is titled DHREJA PACE PML REGISTER. This report lists all 5016s that were sent to the PACE facility to notify them of the patient’s monthly liability.

      C. PACE County Transfer Notices Report

        A report of PACE county transfer cases in XPTR is titled DHRWBD PACE CNTY XFER NOTICE. This report is kept in XPTR for 1098 days and is sorted by county name and number and displays the following information:

        1. PACE recipient name
        2. EIS case ID number
        3. Notice mail date
        4. 60th appeal date
        5. PACE end date

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