Horizon PACE
Horizon PACE is a payer organization operating in Kentucky. For an ASC, what matters isn't the logo. It's how Horizon PACE pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Horizon PACE analysis
Tell us where to send it. Our team will prepare an analysis of Horizon PACE covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Horizon PACE pays
See how Horizon PACE reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
Horizon PACE's presence spans Kentucky. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Horizon PACE and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Horizon PACE's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Horizon PACE up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Horizon PACE
- Payer ID
- R4569 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Horizon PACE through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Horizon PACE members are verified before the date of service, through a clearinghouse using payer ID R4569or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Horizon PACE directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Horizon PACE the way it pays.
- What is Horizon PACE's payer ID?
- Horizon PACE's electronic payer ID is R4569. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Horizon PACE through a clearinghouse.
- How do ASCs verify eligibility for Horizon PACE members?
- Eligibility and benefits for Horizon PACE members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID R4569) or through the payer's provider portal.
- Does Horizon PACE require prior authorization for ASC procedures?
- Prior-authorization requirements for Horizon PACE are set per plan and per procedure. Confirm whether an authorization is required with Horizon PACE directly before the date of service.
- What type of payer is Horizon PACE?
- Horizon PACE is a payer organization operating in Kentucky.
- How does Horizon PACE compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Horizon PACE pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Horizon PACE paying my ASC below market?
- Put your own Horizon PACE contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.