2021| Volume 1
Mercy Care Provider Newsletter
Mercy Care Department of Child Safety Comprehensive Health Plan Implementation
Effective April 1, 2021, we are pleased to announce that the Arizona Department of Child Safety (DCS) and Mercy Care will be implementing a health plan for Arizona’s children and youth called the Mercy Care Department of Child Safety Comprehensive Health Plan (Mercy Care DCS CHP).
Referring, Ordering, Prescribing, Attending (ROPA) - AHCCCS required registration
In our continued effort to ensure providers are aware of the latest news from AHCCCS regarding Referring, Ordering, Prescribing, Attending (ROPA) provider information, we would like to share the latest updates:
Electronic Visit Verification (EVV) Post-Live Updates
Mercy Care is now submitting all prior authorization and service confirmation records for services requiring EVV to the AHCCCS contracted EVV vendor (Sandata). We are also sending claims for EVV services having a Date of Service Start Date of January 1, 2021 to Sandata for claims validation. This means we can now begin to evaluate EVV in action and share 
Social Determinants of Health ICD-10 Coding

As you are aware, beginning with dates of service on and after April 1, 2018, AHCCCS began to monitor all claims for the presence of Social Determinant ICD-10 codes. As appropriate within their scope of practice, providers should be routinely screening for, and documenting, the presence of Social Determinants. Information about any Social


ProPat Reminder

Our On-Line Prior Authorization Search Tool (ProPat) is now available on our website with no log-in. It has been moved from our Secure Web Portal to our Prior Authorization tab/webpage for each line of business. Locations are as follows: 



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.
Colorectal cancer screening initiative
Mercy Care Advantage would like to first thank you for all of your heroic efforts during the difficulties that the healthcare industry faced in the past year by providing ongoing care to members. COVID 19 brought several challenges to the way people received the care they needed,
Mercy Care Advantage's Part B Step Therapy program

CMS allows Medicare Advantage plans to implement Step Therapy requirements for the Part B drugs, therefore starting January 1, 2021 Mercy Care Advantage members will be required to utilize the preferred Part B drugs listed on the CVS Caremark® Medical Preferred Drug List. 
Updated Provider Manuals

Recent updates have been made to two of our provider manuals. We’re attaching a copy of the manuals as well as the Provider Notices that were sent out to view all changes in detail. Changes in the Provider Manual are always highlighted in yellow for quick review.  
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: 
Upcoming Events

The following are upcoming external events/webinars that providers may be interested in attending: 
 
·      Healthcurrent DAP Requirements Flyer  - February 24, 2021
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 semi-annual newsletters. Please feel free to contact our Network Management department through e-mail at: MercyCareNetworkManagement@mercycareaz.org to convey any thoughts or ideas you may have.
Mercy Care is proud to introduce...


Reuben Lopez
Network Relations Consultant
Mercy Care



Reuben Lopez joined Aetna in 2015 in the Provider Data Services (PDS) department. In this role he was responsible for Mercy Care provider updates in the Claims Adjudication production environment. This included building new records, validating provider registration/licensing and aligning contracts. In 2016 he was recruited to work In Mercy