Provider Resources

McGregor PACE

Billing McGregor PACE

Thank you for providing care to our participants!

We want to provide a seamless and easy billing process for our ourtside providers. Below outlines the frequently asked questions from providers about billing the McGregor PACE Program.

Authorization

McGregor PACE requires authorizations for services that are referred outside of our clinics. We provide the authorization number in the paperwork that accompanies our participants to their appointment. If you do not receive the authorization number from the participant at the time of the appointment, please contact our offices at 216-791-3580 to obtain the authorization number prior to providing services.

Emergency Visits

Providers may provide emergency services that are medically necessary without an authorization number. Providers must notify McGregor PACE no later than the next business day from the emergency visit.

Admission for an inpatient stay due to emergency visits requires authorization. Contact 216-791-3580 anytime, day or night. Clinicians are available 24/7.

Claim Submission

Please submit claims within 120 days from the date of service to:

McGregor PACE/eClusive
7700 Equitable Drive
Suite 103
Eden Prairie, MN 55344

For electronic claim submission (Emdeon/Change Health) payer ID: 31149

eClusive is our third-party administrator for claims. They can assist you with claim status including payment and/or denial information. We ask to allow 30 days from the claim submission prior to follow up. eClusive can be reached via phone 952-400-7600 or fax 877-893-7044.

Payment

Interested in signing up for electronic funds transfer? Please copmlete the EFT form and return to eClusive with a voided check or bank letter to mcgregorpace@eclusive.com.

Electronic Funds Transfer Form

Appeal Submission

In the event McGregor PACE denies your claim, you may submit an appeal directly to the Plan requesting reconsideration of the decision. Appeal must be received by McGregor PACE within 120 days from the date of the claim denial. All appeals must be submitted to:

McGregor PACE
14900 Private Drive
Cleveland, OH 44112

Attention: Appeals

Or you may submit your appeal to claims.appeals.pace@mcgregoramasa.org. Note: Providers are responsible for sending their patient's PHI and PII securely.

McGregor PACE will respond to your appeal in writing within 60 days from receipt of the appeal. Please allow 60 days from appeal submission to follow up on status. You can contact McGregor PACE at 216-851-8200 (ask for the appeals department)  for status of your appeal.