NEW PROVIDER ORIENTATION Important Documents
HOW TO WORK WITH US
  • Our plan members are seen by their Primary Care/ Geriatricians (PCP) on site of Serenity Care PACE: 604 Cottage street, Springfield, MA 01104
  • Once the PCP determines a need for specialty care, our staff will make arrangements for the following:
    • Call your office for an appointment for the participant
    • Arrange for transportation to and from the appointment
    • Provide translation during the appointment, in person
    • Assure appropriate work up/ diagnostic testing is performed and communicated to your office prior to the appointment  
    • Send your office patient referral/ authorization with demographic and pertinent clinical information and requests will be sent to your office prior to the appointment. 
  • PLEASE NOTE THAT ALL SPECIALTY SERVICES AND FOLLOW UP VISITS REQUIRE AUTHORIZATION.
  • In case the authorization is not submitted prior to the patient appointment, please check the authorization status by calling the Authorization hotline at (413) 241-6321

HOW TO REQUEST AUTHORIZATION
  • Please call the authorization hotline to request an authorization for services. The number is (413) 241- 6321.
  • You may be asked to leave a message. Please leave the best time for a returned call; all calls are returned within 24 hours.
  • Authorizations forms are completed by our authorization specialists.
  • A verbal telephone confirmation is sufficient in case of urgency; however, the authorization must be obtained PRIOR to the patient’s appointment.

WHAT DO WE REQUEST OF YOU
  • PROVIDE ONLY THE CARE REQUESTED ON THE REFERRAL FORM
  • FAX, mail or send a secure email of your visit notes or requests authorization for further care.
  • Give any prescription needed to the members to bring back to Serenity Care PACE to fill or fax prescription to  (413) 747-3979  

GET PATIENT INFORMATION
  • Find essential coverage information on member’s ID card. 
  • Check eligibility on the day of the service by calling our provider services at (413) 241-6321. Have member ID number ready.

HOW TO GET PAID
SERENITY CARE PACE REPLACES MEDICARE AND MEDICAID COVERAGE
  • Please make sure you have sent your report/ notes of the member’s visit prior to submitting a claim (FAX /Mail/ secure email). Claims will not be paid without supporting documentation of the provided service/s.
  • Please bill Serenity Care PACE for authorized services provided. Claims should be completed as if billing Medicare (same claim requirements).
  • Serenity Care PACE can accept either paper (mail or FAX) or electronic claims.
    •  File claims through an electronic data interchange
    • Secure file transfer protocol (SFTP) Direct Submission
    • Clearinghouse submissions payer ID 27034
    • To get started or ask questions about submitting electronic claims, call us and ask to speak with the operations specialist

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Authorization phone:   (413) 241-8967
Authorization fax:   (413) 747-3979 or (413) 734-0046
Claim inquiry:   (413) 241-8967

Email: Claims@peakpacesolutions.com
 
Claim Address:
Peak Pace Solutions
PO Box 30760
Tampa, FL 33630
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​Serenity Care Pace's EDI Payer Number is 27034