This is an important reminder about your contractual responsibility to help ensure Mercy Care has current and accurate information on file for you. If you experience a demographic change or want to terminate your contract with Mercy Care, it is critical to communicate this type of change to Mercy Care in a timely manner.
We use the provider demographic information we have on file to produce our on-line and hard copy provider directories. Inaccurate provider information can negatively impact member access to care. As a reminder, our provider manuals are an extension of your Mercy Care contract and contain the following important information about your contractual responsibilities.
According to Mercy Care's Provider Manual under
Chapter 4 - Provider Responsibilities, Section 4.33 - Contract Additions and Terminations
, as well as
Section 4.35 - Contract Changes or Updates
, it states:
Section 4.33 - Contraction Additions and Termination
- T
o meet contractual obligations and state and federal regulations, providers must report any terminations or additions to their contract at least 90 days prior to the change. Providers are required to continue providing services to members throughout the termination period.
Section 4.35 - Contract Changes or Updates
- Providers
must
report any changes to demographic information to Mercy Care at least 90 days prior to the change to follow contractual obligations and state and federal regulations. Providers are required to continue providing services to members throughout the termination period.
Mercy Care is audited by our internal compliance departments and our regulators, CMS and AHCCCS, on the accuracy of provider demographic information contained in our provider directories. Audit results have identified inaccurate
demographic provider information, due to not receiving timely notification of changes from many of our providers. Not notifying Mercy Care timely of changes could result in financial ramifications.
Mail change notifications to:
Mercy Care
Attention: Provider Relations
4755 S. 44th Place
Fax change notifications to:
Mercy Care - 860-975-3201
Mercy Care RBHA - 860-975-0841
Email change notifications to:
Below are the changes that require a 90 day notice to Mercy Care prior to a change:
- Individual or Group Name - Must be faxed, mailed or emailed to the above address with an updated W-9 and letter describing change and the effective date of the change to Provider Relations.
- Tax ID number - Must be faxed, mailed or emailed to the above address with an updated W-9 and letter describing change and the effective date of the change to Provider Relations.
- Address and Phone Number Change - Must be faxed, mailed or emailed to Provider Relations.
- Staffing Change Including Physicians Leaving the Practice - Must be faxed, mailed or emailed and include a letter describing the change and the effective date of the change to Provider Relations.
- Adding New Office Locations - Must be faxed, mailed or emailed and include a letter describing change and the effective date of the change to Provider Relations.
- Adding New Physicians to Current Contract - Must faxed, mailed or emailed and include a letter describing change and the effective date of the change to Provider Relations.
- Number of Beds Usage (i.e., Reducing Residential Beds) - This must be pre-approved by our Network Administration. Notification must be faxed or mailed and include a letter describing the change and the effective date of the change to Network Management at the above fax number and physical address. Notification can also be emailed to [email protected].
- For providers who render services at more than one service location, CMS and AHCCCS expect the Provider Directories to include the actual dates providers are at each location, because the regulators know providers cannot service all locations on the same date. If you provide services at more than one service location, we need you to provide the days and times at each location. For example:
Correct Submission
John Smith M.D.
159 State Street
Monday 8-5, Wednesday 8-5, Friday 8-3
and
753 Jupiter Street
Tuesday 9-5, Thursday 9-5
Incorrect Submission
John Smith M.D.
159 State Street
Monday through Friday 8-5
and
753 Jupiter Street
Monday through Friday 8-5
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!
