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.
As a reminder, the provider manual is an extension of your contract. Mercy Care is audited by both of our regulators, CMS and AHCCCS, on the accuracy of information contained in our Provider Directory. Based on these audits, it has been determined that we are not receiving timely notice from many of our providers, reflecting poorly on our audit results to date.
Not notifying Mercy Care timely of these changes could result in financial ramifications. You may mail your changes to:
Mercy Care
Attention: Provider Relations
4755 S. 44th Place
Phoenix, AZ 85040
Or you may fax any changes to:
Mercy Care - 860-975-3201
Mercy Care RBHA - 860-975-0841
Below are the changes that require a 90 day notice to Mercy Care prior to a change:
- Individual or Group Name - Must mail to the above address updated W-9 and letter describing change and effective date to Provider Relations.
- Tax ID number - Must mail to the above address updated W-9 and letter describing change and effective date to Provider Relations.
- Address and Phone Number Change - Must fax or mail to Provider Relations.
- Staffing Change Including Physicians Leaving the Practice - Must fax mail letter describing change and effective date to Provider Relations.
- Adding New Office Locations - Must fax or mail letter describing change and effective date to Provider Relations.
- Adding New Physicians to Current Contract - Must fax or mail letter describing change and effective date to Provider Relations.
- Number of Beds Usage (i.e., Reducing Residential Beds) - This must be pre-approved by our Network Administration.
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!
