Prior Authorization Code Changes
Attention providers! Mercy Care has removed hundreds of codes requiring prior authorization from our grids. We did this to reduce some of the administration involved in being part of our provider network.
Prior Authorization Code Changes – FAQ
Pima County providers
Mercy Care is proud to continue serving ALTCS, DDD and Mercy Care Advantage (MCA) members in Pima County.
Mercy Care is experiencing a high volume of inquiries from members in Pima County who are enrolled in DDD, ALTCS and Mercy Care Advantage (MCA). These members are stating that their providers are informing them of contracting changes related to the AHCCCS Complete Care contract.
Please note: the 10/1 changes for the new AHCCCS Complete Care (ACC) program do not impact current DDD, ALTCS and MCA members in any GSA.
Mercy Care remains contracted with AHCCCS to provide services to members enrolled in ALTCS, DDD and MCA. If you have any questions please contact your Provider Relations Representative.
Fast, Easy Answers to Your Questions
Mercy Care’s new Interactive Voice Response, or IVR, system, makes it easy to get member and claims information 24/7. You can:
- Access member benefits and eligibility information
- Get answers to Frequently Asked Questions ‑ such as appeals address, payer ID, etc.
- Obtain claim status at header level
- Obtain claim status at line level
- Obtain amount paid on a specific claim
- Request single claim information by fax
Find out more here. IVR is available to Mercy Care RBHA providers Thursday, 9/20 and to all Mercy Care providers Wednesday, 9/26.
Join our network
We are committed to providing quality health care services to our members. And our credentialing and contracting processes help us achieve that goal.
To be eligible to join the Mercy Care and Mercy Care Advantage networks as a provider, you must do the following:
- Correctly and completely submit the credentialing application
- Be fully credentialed by Mercy Care or Mercy Care Advantage
- New providers will receive a Participating Health Provider Agreement (contract). Providers joining an existing group must complete the applicable contract documents to be added to the existing contract.
- Sign and return all contract documents.
- Upon completion of credentialing and full execution of contract documents, the provider will receive notice from the Mercy Care Network Development department with the effective date of participation, along with the fully executed contract (if it is a new contract).
Providers should not schedule or see Mercy Care members until they are notified of the participation effective date.
If you have questions about the process, contact your Provider Relations representative at 602-263-3000.
If you are interested in contracting with Mercy Care or Mercy Care Advantage, you must complete the following steps and return appropriate listed application documents:
A Letter of Interest (LOI) should be faxed to Mercy Care at 1-860-975-3201. The LOI should be on the provider’s letterhead and must include the following:
- AHCCCS ID number
- Medicare ID number (if applicable)
- Geographic location
- Provider specialty and services/facility
Please submit the following forms with your LOI: