Enrollment Management / Billing / Reconciliation

Enrollment Management  / Billing / Reconciliation Peak PACE Solutions submits your monthly enrollment file to CMS in a timely manner. We verify that the PACE organization is receiving the proper payment from CMS.

Peak Enrollment Management/Billing/Reconciliation services include:

  • Enter enrollment and disenrollment information as provided by client
  • Generate and print insurance cards
  • Monthly verification of proper payment from CMS related to: State & County Code, Institutional Indicator, ESRD Status, Part D bid, Low-income subsidy, Reinsurance subsidy, and PACE cost sharing
  • Maintain an up-to-date enrollment activity file for each participant
  • Allow access to our intake/enrollment system to complete an intake worksheet electronically at the prospective enrollee’s home
  • Provide the ability to print the intake worksheet for introduction to your Interdisciplinary Team
  • Allow you access to track referral sources if PO uses the PPS intake/enrollment module
  • Give you access to reports to track when/why prospective enrollees withdraw from the process
  • Submit your enrollment/disenrollment file to CMS
  • Annual verification of proper CMS capitation rates paid per CMS’ ratebook
  • Provide your Monthly Membership Report (MMR) in Excel format