2020| Volume 2
Mercy Care Provider Newsletter
Keep current on COVID-19
Mercy Care continues to monitor the COVID-19 (coronavirus) pandemic outbreak, gathering information from trusted sources of clinical information such as the Centers for Disease Control (CDC) and World Health Organization (WHO), the Arizona Department of Health Services, and all county public health organizations. It’s important to know where to get the information you need for the questions you may have.
COVID-19 emergency medical coding guidance from AHCCCS and CMS
Many in our provider network have been asking for guidance for billing telehealth claims during this COVID-19 emergency. We received a document from AHCCCS dated 3/17/2020, COVID-19 Emergency Medical Coding Guidance, that helps to answer questions about billing telehealth services. Please click the link to view the document in its entirety.
Introducing our new Network Management department

Recently Mercy Care’s Provider Relations Department and Contracting Department have merged into one department – Network Management. Our Network Management department is your touchstone to everything Mercy Care. The combined department was formed to create better efficiencies between our old Provider Relations and Contracting teams and is led by Patricia Weidman, Director, Network Management.
Constant Contact: Sign up to stay connected

As part of Mercy Care’s comprehensive communication strategy, we use Constant Contact, an email marketing vendor, to assist us in getting important information directly to our providers via email. 

We continue to post all provider communications to our website.

Contract changes or updates 
We periodically like to remind our provider network of the importance of notifying Mercy Care of any demographic or contract changes. In Chapter 100 - Mercy Care Provider Manual – General Terms, under Chapter 4 – Provider Responsibilities, section 4.39 - Contract Changes or Updates it indicates:
Blood Pressure thresholds and recommendations for treatment and follow-up

In 2018 the American Heart Association (AHA) changed the recommended blood pressure thresholds. Following the new recommendations may mean some of your patients are now considered to have above normal blood pressure and need to be more closely monitored.

Colorectal cancer screening initiative

June 2020 to improve the rate of members being screened for colorectal cancer. The PCPs of members between 50 - 75 years of age who, by review of claims, have not received an appropriate colorectal cancer screening in the recommended timeframe will be receiving a letter and Fecal Immunochemical test (FIT) order form. The Fecal Immunochemical test (FIT) is one of the least invasive screening methods, offering an additional opportunity for members to meet compliance.
Billing outpatient date span claims

Mercy Care provides the following guidance for appropriate billing of date spans in a claim.
Time Based CPT Code

As a reminder, when a CPT code is defined by time, the provider must document time in the patient’s medical record. Examples of this include some psychiatry codes, certain physical therapy modalities, critical care, the second level discharge visit and any prolonged services. When you look at the definition of a CPT code, and time is listed, the time must be documented in the medical record. Failure to do so may cause audit issues, as the code billed may not be able to be substantiated by medical record documentation.
Fraud, Waste and Abuse Alert - Questionable use of drugs in Footbaths

The Centers for Medicare & Medicaid Services (CMS) has identified questionable use of drugs, primarily antibiotics and antifungals, which are being used in a footbath. Beneficiaries are being instructed to mix these drugs with water and then soak their feet. This footbath claims to treat or prevent diseases such as diabetic ulcers, bone infections, ingrown toenails, pitted keratolysis and cellulitis.
Mercy Care Advantage Model of Care Training for 2020

The 2020 Mercy Care Advantage Model of Care Training is now available for your use. The training course incorporates an attestation statement in it so that you will no longer have to fax in a separate attestation after you complete the course. As you know, this is an annually required course for any provider treating Mercy Care Advantage patients.
Recent provider notifications

Mercy Care’s provider notifications contain important information for your use. Please click on the links to view the most recent provider notifications in greater detail:  
Recent Provider Forms

Provider Forms are added as needed for provider use. New forms since our last provider newsletter include:

Recent Reference Material and Guides

Reference Materials and Guides contain valuable information you may refer to at any time. Recent Reference Material and Guides include: 
We want to hear from you!

This is your provider newsletter! We want to hear from you regarding any topics you would like us to cover in our quarterly newsletters. Please feel free to contact our Network Management department through e-mail at: MercyCareNetworkManagement@mercycareaz.org to convey any thoughts or idea you may have.
Mercy Care is proud to introduce...

Laura Nguyen
Manager, Network Management
Mercy Care

Laura Nguyen is currently a manager in our Network Management department and is overseeing Network Relations Consultants/Specialists and Network Contract Specialists. The team is responsible for all emails and faxes that come through Network Management (formerly Provider Relations and Contracts) as well as non-par/out of state provider matters. Laura connects with several internal teams to ensure provider set up in our system is accurate and fully functional.