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.

Allwell from Home State Health – Referral Requirement

August 06, 2019

Please review the attached information regarding a change in referral requirements for Allwell from Home State Health.

Allwell Referral Requirement Removed 080619

Anthem Missouri Updates – Rehabilitative Program Update

July 03, 2019

Anthem Blue Cross and Blue Shield (Anthem) previously communicated in the April 2019 edition of Anthem Provider News that AIM Specialty Health® (AIM), a separate company, would begin to perform prior authorization review of rehabilitative (restoring function) and habilitative (enhancing function) services for Anthem fully insured members beginning July 1, 2019. Due to recent group membership, provider status, and system issues experienced by Anthem and AIM, the program will now be implemented on August 1, 2019.

Please review attached update.

Anthem Missouri Update – Rehabilitative Program Update

Meeks Building Centers Contract Update

June 20, 2019

We’ve been made aware that as of 01/01/2019 Meeks Building Centers will not be accessing Mercy and their affiliates via a direct contract.  Meeks is now obtaining care through Cigna and your participation will be based on your contract status with Cigna.

Claims run-out was handled by Med-Pay through 03/31/2019.

 

 

Home State Medicaid Faxblast

June 20, 2019

Please review the attached for billing guidelines when behavioral health services are billed by non-behavioral health providers.

Depression_BipolarAwareness Faxblast