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. Please see the additional resources below that are available to you to confirm specific contract participation.

  • Mercy Network LLC providers: If you are participating with Mercy via a contract with Mercy Network LLC (this would include providers in Southwest Missouri,  Northwest Arkansas, Oklahoma and select providers in St. Louis), please reference your online matrix for specific contract participation.
  • Mercy PHO providers: If you are contracted with Mercy via the Mercy PHO (this would include the majority of providers in the St. Louis region), please reference your PHO contract and enrollment packet for a listing of the contracts you hold through Mercy.
  • Mercy employed/integrated providers in the St. Louis region: Please continue to reference the Managed Care hub on Baggot Street, and the Sharepoint site as your reference for contract participation.
  • All other Mercy employed/integrated providers: Please continue to use the Managed Care hub on Baggot Street as your reference for contract participation.

Provider Changes
As a contracted provider, it is important to notify us immediately of changes to your practice 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 – Connect Individual & Family Plan

October 31, 2019

Please review the attached notice from Cigna regarding their Connect Individual & Family Plan.

Cigna is announcing that their Connect plan will become effective in four additional counties in the Kansas City area.  However, please remember that while we will continue to be participating providers in other Cigna networks, Mercy providers in the North Central Region WILL NOT be in network for the Cigna Connect Individual & Family Plan that is marketed and sold in the Kansas City and St. Louis areas.  These plans require enrolled customers to use only Connect Network participating providers and there are no benefits for out-of-network services, unless it’s for a medical emergency.

A sample identification card is included on the attached flyer for your reference.

Cigna – Connect Individual and Family Plan

Cigna – Express Scripts Pharmacy Transition

October 31, 2019

Please review the attached notice from Cigna regarding their transition to Express Scripts Pharmacy for home delivery along with changes to their electronic prior authorization process.

Cigna – Express Scripts Transition

Cigna – Drug Formulary Changes Effective January 1, 2020

October 21, 2019

Please review the attached notice from Cigna regarding changes to their drug formulary effective January 1, 2020.

Please note that Cigna will be sending a letter to all patients affected by the change in their drug formulary; therefore, providers may be contacted directly by these patients to discuss their drug alternatives.

Cigna – Drug Formulary Changes 010120

Allwell from Home State Health – Provider Notice

October 11, 2019

Attached is a handout from Allwell by Home State Health regarding their upcoming open enrollment period.  All Mercy providers will continue to be IN NETWORK for the Allwell plans in 2020.

Products: Allwell Medicare Advantage Plan and Medicare/Medicaid Dual Eligible Plan

Provider Notice Contains:

  • Annual Enrollment Period starts on October 15 and ends on December 7, 2019
  • Benefit Overview
  • 2020 County Expansion

If you have any questions please contact Provider Services at:

HMO plans 1-855-766-1452 • HMO SNP plans 1-833-298-3361

HSH MO Allwell AEP provider email notice 2019 10-8

Home State Health Plan Current Provider Report

October 09, 2019

Attached you will find the current Home State Health Medicaid Provider Report.