Provider Notifications

Provider Notifications are designed to furnish you with any new or important communications from Mercy Care in order to assure you have the most up to date information from us.

We have recently posted our new Claims Processing Manual to our website located on our Claims Information web page. Many of our previously listed provider notifications are related to claims processing and have been incorporated into our Claims Processing Manual. We are in the process of archiving these notifications in order to assure the most relevant information is included in the provider notifications list below.

Please use the below links to review important information and current provider notifications.

• 2017 AHCCCS Provider Survey  Document Date:  12/04/2017 
• 5-day supply limit of prescription opioid medications  Document Date:  11/27/2017 
• Acute Skilled Nursing Facility Authorization Process Change  Document Date:  05/17/2016
• After Hours Updated Call Tree for Prior Authorization and Utilization Management  Document Date:  06/09/2016 
• AHCCCS Complete Care award  Document Date:  05/03/2018 
• AHCCCS Complete Care message  Document Date:  09/14/2018  NEW
• ALTCS eligibility determinations during hospitalization  Document Date:  0920/2017
• Behavioral Health Residential Facility (BHRF) provider documentation  Document Date:  02/09/2018 
• Behavioral heath treatments by PCPs  Document Date:  04/30/2018  NEW
• Billing Therapy Services for a Custodial Skilled Nursing Facility  Document Date: 01/02/2015
• CareWebQI Direct Entry Prior Authorization Requests  Document Date:  09/09/2015
• Change Healthcare (Formerly Emdeon)  Document Date:  01/20/2016 
• Change in coverage for dental services for members who are 21 years and older  Document Date:  10/06/2017 
• Change in coverage for occupational therapy services for members 21 years of age and older Document Date:  10/06/2017 
• Change in prior authorization requirements Document Date:  01/12/2018 
• Constant Contact - e-mail alerts  Document Date:  11/30/16 
• Controlled Substances Prescription Monitoring Program registration  Document Date:  04/28/2017 
• Cross claim adjudication technology  Document Date:  02/21/2017 
• Discarded physician-administered medicines  Document Date:  01/18/2018 
• D.R.E.A.M. Job Fair - April 2018  Document Date:  03/09/2018 
• Electronic visit verification survey  Document Date:  02/27/2018 
• Emergency dental services for members 21 years of age and older  Document Date:  10/06/2017 
• End of life care  Document Date:  10/20/2017 
• Enhancement to Secure Web Portals - attachments  Document Date:  04/07/2017 
• Expedited service authorization requests  Document Date:  08/31/2017 
• eviCore healthcare - prior authorization for pain management services update  Document Date:  06/27/2017 
• eviCore healthcare - prior authorization for pain management - no prior authorization required until 08/23/2017  Document Date:  08/14/2017 
• Formulary change effective July 1, 2018  Document Date:  06/29/2018  NEW
• Formulary Change - Epipen  Document Date: 10/08/2015
• FQHC reimbursement for case managment and behavioral health technicians  Document Date:  03/03/2017 
• FQHC - rendering provider NPI in box 19  Document Date:  04/06/2017 
• Gabapentin abuse  Document Date:  07/27/2018  NEW
• Gender Specific Editing Rules  Document Date:  05/20/2016
• Hill-Rom - Clinitron Beds  Document Date:  10/11/2016 
• Home and Community Based Services - Rate Increase Effective October 1, 2016  Document Date:  09/07/16 
• Home and Community Based Services rate increase update for January 1, 2017  Document Date:  02/20/2017 
• Homeland Security update - multiple ransomware infections reported  Document Date:  05/12/2017 
• ICD-10 Implementation  Document Date: 09/28/2017
• Implementing the new federal IMD regulation  Document Date:  09/05/2017 
• Important provider notice regarding AHCCCS eligibility and enrollment Document Date:  09/19/2018  NEW  
• Incontinence Briefs - Added Coverage  Document Date: 09/24/2015
• Infusion network change  Document Date:  03/02/2018
• Inpatient retrospective auditing by Medical Audit & Review Solutions (MARS)  Document Date:  07/24/2017 
• Long-acting opioids to require prior authorization effective 1/1/2017 clarification  Document Date:  01/30/2017 
• Long-acting opioids to require prior authorization effective 1/1/2017  Document Date:  12/21/2016 
• Makena - billing change  Document Date:  12/13/2016 
• Maternity care for members with developmental disabilities  Document Date:  04/04/2017 
• Mercy Care ClaimConnect  Document Date:  02/19/2016
• Mercy Care Plan October 1, 2016 Formulary Changes  Document Date:  09/29/2016 
• Mercy Care relocation Document Date:  09/28/2018  NEW
• MercyOneSource - New Secure Web Portal
• MercyOneSource Secure Web Portal and CareWebQI Frequently Asked Questions  Document Date: 12/09/2014
• Multiple Petya Ransomware infections reported  Document Date:  06/28/2017 
• Mumps alert from the Arizona Health Alert Network  Document Date:  05/02/2017 
• New Pharmacy Prior Authorization Fax Form for Hepatitis C Medication  Document Date: 07/30/2015
• Non-emergency transportation program integrity review update  Document Date:  04/03/2018  NEW
• Non-emergent transportation - documentation required for trips 100 miles or more  Document Date:  01/10/2018 
• OneLogin - Data Breach Alert  Document Date:  06/02/2017 
• Opioid detox and integrated chronic pain program referral resource - Recovia  Document Date:  07/17/2017 
• Orthotic Devices: Change in Coverage  Document Date: 08/05/2015
• Osteopathic Manipulative Therapy: Prior Authorization Alert  Document Date: 08/06/2015
• Outlier inpatient hospital claims  Document Date:  04/07/2017 
• Oxycontin formulary removal effective 1/1/2018  Document Date:  11/27/2017 
• Pain management network change  Document Date:  09/22/2017 
• Parsabiv and Sensipar - approval for renal dialysis services  Document Date:  01/05/2018 
• Pharmacy Formulary Change - Test Strips  Document Date: 01/13/2015
• Podiatry Services - Change in Coverage  Document Date:  08/19/2016 
• PopHealthCare Strategic Collaboration with Mercy Care Long Term Care  Document Date: 11/20/2014
• Post Office box change for refunds  Document Date:  02/01/21018 
• Primary Care Physician (PCP) Change Form  Document Date: 10/07/2014
• Prior authorization change  Document Date:  09/25/2018  NEW
• Prior authorization - HCPCS codes T1002 and T1003 - Document Date:  09/22/2017 
• Prior authorization is no longer required for wheelchair repairs  Document Date:  01/25/2017 
• Profax - New Capability to Submit Electronic Disputes  Document Date: 01/22/2015
• Proposition 206 - rate and capitation adjustment  Document Date:  12/15/2017  
• Provider Manual Updates - July 2018  Document Date:  07/02/2018  NEW
• QMB Cost Sharing Policy Change
• Radiology Authorizations
• Reclassification of Hydrocodone Combination Products  Document Date: 10/02/2014
• Reimbursement for Status B indicators  Document Date:  08/23/2017 
• Remittance Issue: Denial Messages on Paper and 835 Remits  Document Date: 10/28/2015
• Request for Information - Autism Center of Excellence  Document Date:  11/09/2016
• Request For Information - Autism Center of Excellence - deadline extended  Document Date:  12/05/2016 
• Request For Information: Family Center  Document Date:  01/12/2017 
• Request For Information: Family Care FAQs  Document Date:  01/12/2017 
• Seclusion and Restraint reporting for Mercy Care Plan and Mercy Maricopa  Document Date:  12/01/2017 
• Second Mercy Care Plan Long Term Care Check Run  Document Date:  01/14/2016 
• Secure Web Portal - submitting attachments  Document Date:  07/10/2018  NEW
• Skilled Nursing Facility Billing for Custodial Care Effective 10/1/2017  Document Date:  08/28/2017 
• Skilled Nursing Facilities (SNF) Bariatric Services
• Skilled Nursing Facility Rate Increase Effective October 1, 2016  Document Date:  09/07/2016 
• Skilled Nuring Facility rate increase update  Document Date:  02/20/2017 
• Skilled Nursing Facility Transportation Update  Document Date: 03/04/2015
• Smoke-free HUD public housing policy  Document Date:  02/22/2018 
• Social Determinants of Health - NORC study  Document Date:  03/09/2018 
• Synagis - Information for 2015-2016  Document Date: 09/08/201
• T1016 - Case Management is not covered under Mercy Care Plan Long Term Care  Document Date:  02/22/2018 
• Telephone Interpretation Services
• Treating Attention Deficit/Attention Deficit Hyperactivity, Depression and Anxiety  Document Date:  05/16/2017 
• Unlisted CPT/HCPCS Codes  Document Date:  08/02/2017 
• Use of Social Determinants of health codes for member outcomes update  Document Date:  02/08/2018   
• Utilization Management Process Notification
• Vaccine for Children re-enrollment by June 30, 2018  Document Date:  06/08/2018  NEW
• Void Requests  Document Date:  04/06/2018  NEW
• Welcome to Mercy Care!  Document Date:  07/01/2018  NEW