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 Updates First Quarter, 2020

November 25, 2019

Please review the following policy updates and changes that Cigna will implement during the first quarter of 2020.

  • Allergy Testing and Non-Pharmacologic Treatment
  • Anesthesia Services for Interventional Pain Management Procedures (Adults)
  • Care Integration Services
  • Evaluation and Management and Joint Injection Codes
  • Incontinence Supplies

Cigna – Policy Updates First Quarter 2020

Ambetter Payment and Clinical Policies Update

November 19, 2019

Please see the attached provider notice regarding payment and clinical policy updates for the Ambetter program that will be effective on January 15 2020.

Please keep in mind that this only applies to the Ambetter program.

Ambetter Payment and Clinical Policies Effective 011520

Home State Health Synagis Injections

November 13, 2019

Please view the attached reminder from Home State Health-Medicaid regarding Synagis injections.

SynagisProvdrLetterfromHSH

Ambetter from Home State Health Provider Notice for 2020

November 05, 2019

Product:  Ambetter from Home State Health (Marketplace)

Good morning,

Attached, please find our Ambetter from Home State Health Provider Notice regarding 2020, which includes a thank you for being partners in care!  We reference resources on our website www.Ambetter.HomeStateHealth.com, along with key benefit information and our 2020 geographic map, noting where our Ambetter members in 2020 reside.   Marketplace Open Enrollment began on November 1st and continues until December 15h.

Please review this information within your group/practice as necessary.

Ambetter 2020 Provider Notice