We strive to make information readily available to your office. We understand that your office is affected by any changes to the contracts that you hold through Mercy Managed Care. In efforts to keep you updated, this section is designed to update you on contract information including: new contracts, contract terminations, rate updates, TPA changes, and miscellaneous other news.

Please be aware that not all rate changes or contract updates below will necessarily pertain to everyone. We are also not able to publish specific rate information online as that data is confidential: you can however, view your contract listing and rate information via the online rate matrix. A designated staff member at your organization should have login information to access this file. If you are contracted through a PHO, please contact your PHO representative if you have questions regarding your Mercy Managed Care Contracts.

Provider Changes

As a contracted provider, it is important to notifiy us immediately of changes such as: a new provider joining the practice, changes in billing information, provider leaving the practice, or adding a new clinic location.  Notification may help avoid claim denials.  Please submit changes by fax 417-820-3821 or email. Please include a W-9 Form if the change involves a new billing address or tax identification number.

Cigna Policy Update – Peripheral Angioplasty Procedures 4/1/2019

January 08, 2019

Cigna is implementing a new medical coverage policy to review peripheral angioplasty procedures for medical necessity.  This policy will be effective for dates of service beginning April 1, 2019.

Cigna Policy Update – Peripheral Angioplasty Procedures 04.01.2019

Home State Health Provider Notice: Additional Dx. Code Requirement with Autism Spectrum Disorder (F84.0)

November 16, 2018

Please review the attachment and email from Home State Medicaid regarding diagnosis coding for Autism Spectrum Disorder.  Please share this as appropriate.

 Additional diagnosis code requirement with Autism Spectrum Disorder (F84.0) 

 AutismSpectrumDisorderAdditionalDxCode 111618

 

 

 As a reminder, Coding and Risk Adjustment Awareness information is housed on their website at :  https://www.homestatehealth.com/providers/tools-resources/coding-page.html

 

 IMPORTANT UPDATE

All claim inquiries are to be directed to the Claims Integrity Team with each product having a dedicated team to contact.

Home State Health/Medicaid: 855-694-4663

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Home State Medicaid Oxygen Coding Errors

November 16, 2018

Home State Medicaid has identified some common billing errors when coding for oxygen.  They’ve asked that you share this communication with anyone who would be coding this service as a reminder of how it needs to be submitted.

RA_Issue_11_Oxygen_Supplementation