Services

• Claims Adjudication & Payment
• Enrollment Management, Billing & Reconciliation
• Reporting
• Risk Adjustment
• Encounter Processing
• Medicare Part D
• Accounts Receivable
• Coordination of Benefits, Medicare Secondary Payer (MSP)
• Home

Enrollment Management, Billing & Reconciliation

Peak PACE Solutions provides comprehensive enrollment management, billing and reconciliation services. Services in this area 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 IDT 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

To learn more about our Enrollment Management, Billing and Reconciliation services or to schedule a demonstration of our system, please contact us at 720-204-3361 or info.peakpacesolutions.com.