June 12, 2019
Notification of admission at Sub-Acute facility

Applicable to: Mercy Care Complete Care and Mercy Care RBHA

All new admissions and continued stays for admissions to Sub Acute facilities (Provider Type B5 and B6) for Mercy Care members will require notification of admission in accordance with the AHCCCS Medical Policy Manual (AMPM) 1020 - Medical Management Scope and Components. This does not include RBHA Block payment for sub-acute beds.  Mercy Care is implementing the following process for notification of admissions and continued stays for Sub Acute facilities.
Starting June 17, 2019, Mercy Care will start to accept notifications for new and continued stay admissions. Claims will continue to be paid up to July 22, 2019 (benefit, frequency and non-covered service limitations will still apply). Starting July 22, 2019, authorizations for new admissions and continued stays with dates of services July 22, 2019 and after will be required.  Services rendered without authorization may be denied for payment. 
All new admissions starting June 17, 2019 will require notification of admission within 24 hours of admission. This must include appropriate clinical assessment that includes the discharge plan and indicating who is coordinating care and/or the Certificate of Need (CON). Members who have a continued stay beyond 3 days of admission will require an updated discharge plan, including who is coordinating care. This information must be faxed to 855-825-3165. 

As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

Thanks for all you do!