September 25, 2018
Prior authorization update

Applicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care, Division of Developmental Disabilities and Mercy Care Advantage
Mercy Care has eliminated prior authorization for approximately 1,300 service codes that currently require prior authorization.  This change will take effect October 1, 2018.

We’re doing this because we:
  • Want to help reduce administrative burden for providers
  • Want to speed up access to care for members, especially those with complex needs
  • Will focus more of our efforts on addressing the social determinants of health
  • Will continue to promote integrated, value-based care as our provider payment strategy
The new prior authorization process will go into effect for dates of service October 1, 2018 and later. For your convenience, we are attaching a list of common questions and a list of the codes that will continue to require prior authorization. 

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!