Mercy Care Advantage
Fast, Easy Answers to Your Questions
Mercy Care’s new Interactive Voice Response, or IVR, system, makes it easy to get member and claims information 24/7. You can:
- Access member benefits and eligibility information
- Get answers to Frequently Asked Questions ‑ such as appeals address, payer ID, etc.
- Obtain claim status at header level
- Obtain claim status at line level
- Obtain amount paid on a specific claim
- Request single claim information by fax
Find out more about IVR.
Join our network
We are committed to providing quality health care services to our members. And our credentialing and contracting processes help us achieve that goal.
To be eligible to join the Mercy Care and Mercy Care Advantage networks as a provider, you must do the following:
- Correctly and completely submit the credentialing application
- Be fully credentialed by Mercy Care or Mercy Care Advantage
- New providers will receive a Participating Health Provider Agreement (contract). Providers joining an existing group must complete the applicable contract documents to be added to the existing contract.
- Sign and return all contract documents.
- Upon completion of credentialing and full execution of contract documents, the provider will receive notice from the Mercy Care Network Development department with the effective date of participation, along with the fully executed contract (if it is a new contract).
Providers should not schedule or see Mercy Care or Mercy Care Advantage members until they are notified of the participation effective date.
If you have questions about the process, please contact the Network Management Department at:
- E-Mail: MercyCareNetworkManagement@MercyCareAZ.org
- Fax: 860-975-3201
If you are interested in contracting with Mercy Care or Mercy Care Advantage, you must complete the following steps and return appropriate listed application documents:
A Letter of Interest (LOI) should be emailed to MercyCareNetworkManagement@MercyCareAZ.org. The LOI should be on the provider’s letterhead and must include the following:
- AHCCCS ID number
- Medicare ID number (if applicable)
- Geographic location
- Provider specialty and services/facility
If you are unable to email, you may fax your LOI to 1-860-975-3201.
Please submit the following forms with your LOI:
Network Management Department
Our Network Management department serves as a liaison between Mercy Care Advantage and the provider community. Network Management is responsible for training, maintaining and strengthening the provider network in accordance with regulations.
If you need to check on the status of a claim, please use our secure web portal. You may access the portal by clicking on the link in the top upper right hand corner of this web page under Find A Provider. You must be a registered user to access it. To register, please fill out our Registration Form. Please fax to the below number to start the process.
If you have questions regarding a processed claim, either paid or denied, please feel free to contact our Customer Service department at 602-263-3000 or 800-624-3879, Express Service Code 626. Non-participating providers should contact our Customer Service department for all issues, in addition to claims issues.
You can fax directly to Provider Relations at 860-975-3201 the following information:
- Notifying the plan of changes to your practice
- Tax ID changes
- Recent practice or provider updates
- Termination from practice
- Web Portal Registration Form
Please feel free to contact our Network Management department for the following:
- Questions regarding the web portal Registration Form or to check on enrollment status
- Credentialing requirements
- Provider Education
You can reach our Network Management department by calling 602-263-3000 or 1-800-624-3879, Express Service Code 631.
For your convenience, below you can find a listing of your assigned Network Management representative, as well as their detailed contact information:
Quarterly PCP Visits
Our Network Management representatives visit provider offices every quarter. Contact your Network Management representative to schedule an appointment, or to learn when your representative will visit your office.
Mercy Care Advantage Model of Care Training
2020 Mercy Care Advantage Model of Care Training Document Date: 4/30/2020
Additional information about Mercy Care Advantage