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.

Home State Health Provider Notice: Opioid Crisis – Message from Chief Medical Officer

March 15, 2019

Please review and she this important notice from Home State Health’s Chief Medical Office, Dr. Sharon Deans.

 

Products:

Home State Health (Medicaid)

Ambetter from Home State Health (Marketplace)

Allwell from Home State Health (Medicare HMO and D-SNP)

HSH MO ASAM-Provider-Training_Email-1(WebLinks)

Cigna Medical Policy Update – Flow Cytometry Effective 5/20/2019

March 04, 2019

Please review the attached medical policy from Cigna to review the medical necessity of Flow Cytometry.  This policy goes into effect on May 20, 2019.

Cigna – Flow Cytometry 052019

Home State Provider Notice: Prior Authorization Requirement for Outpatient Physical, Occupational & Speech Therapy – Effective June 1, 2019

March 04, 2019

Please review and share the attached announcement from Home State Medicaid regarding a change to their authorization requirements for outpatient physical, occupational and speech therapy.

Medicaid- Therapy Prov Notice 03.01.19

Allwell Provider Notice: Prior Authorization Requirement for Outpatient Physical, Occupational & Speech Therapy – Effective June 1, 2019

March 04, 2019

Please review the attached announcement from Allwell regarding a change to their authorization requirements for outpatient physical, occupational and speech therapy.

Allwell – Therapy Prov Notice 03.01.19

 

Home State Medicaid PROVIDER NOTICE: Independent RHC’s – T1015

March 04, 2019

Please view the provider notice received from Home State Medicaid regarding the billing of T1015 by Independent RHC clinics. 

T1015 IRHC Provider Communication Feb 2019_021819

Anthem Provider Newsletter – Missouri March 2019

March 01, 2019

Copy and Paste the following link:

http://view.messageinsite.com/?qs=ee41cb31c4b727d6491599dd0d578085c032d19a80f1ea8a04f7722ad681cd90f40f6da9a1af821f527660c8928a451ef4aa28a5f1290152d8f5724bce578d2eaa9dbb3e0f26500c

 

Aetna OfficeLink Updates Newsletter – March 2019

March 01, 2019

Copy and paste the following link:

http://links.mkt2161.com/servlet/MailView?ms=MTUxOTE5NTMS1&r=MzQzODYxNjU0MDAzS0&j=MTU4MjAyMjM5MQS2&mt=1&rt=0

 

Allwell – Part B Drugs Prior Authorization Update

February 25, 2019

Please see the attached fax blast regarding Part B Drugs.

Home State Health requires prior authorization as a condition of payment for many services. This Notice contains information regarding such prior authorization requirements and is applicable to all Medicare products offered by Home State Health.

 

It is the ordering provider’s responsibility to determine which specific codes require prior authorization. Effective May 1, 2019, prior authorization requirements will be added to the Part B Drugs. A listing of the Part B drugs that will require prior authorization can be found on our website www.homestatehealth.com, For Providers, Allwell Provider Materials, News and Announcements.

 

Refer to the Pre-Auth Needed tool for services that require an authorization. There is also a list of Frequently Asked Questions on the attached fax blast for your review.

Allwell – Prior Authorization Update Eff_050119_012919