Applicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care, Mercy Care CHP, and Mercy Care DD
Per Arizona Statute and ACOM Policy 205, if Mercy Care does not have a contract with an ambulance company, then Mercy Care must pay 68.59% of the ADHS rate as of the July 1st rates. Any contract between Mercy Care and an ambulance company must abide by the statute and pay the rate based on the timing specified in the statute. The contract cannot override the statute. Mercy Care must use the ADHS fee schedule as of July 1st, which would align with the AHCCCS Fee For Service schedule as of October 1st.
Mercy Care has historically updated ADHS rates each month when rates are posted by ADHS. Beginning October 1, 2021 files, we will be updating the rates once per year and rates will be based on the prior published July 1 rates. The rates will match AHCCCS yearly published rates. In addition, Mercy Care will not perform recoupments for previously overpaid claims.