Welcome providers

As a network provider, you enjoy a lot of benefits, from ongoing support and training to timely claims processing and competitive compensation. Together, we can improve health care access and quality in Arizona. 

You can stay up to date with Mercy Care by joining our email list. 

Fast, easy answers to your questions

Mercy Care’s 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 here.

It’s easy to work with us on Availity®

The Availity Provider Portal gives you the info, tools and resources you need to support the day-to-day needs of your patients and office.

All the tools you need, all in one place

The Provider Portal helps you spend less time on administration. This way, you can focus more on patient care. You get a one-stop shop portal to quickly perform key functions you do every day.

You can:

  • Look up the status of a claim, or submit new claims through Change Healthcare
  • Submit authorizations or check the status of a previously submitted prior authorization
  • Check patient eligibility and benefits
  • Submit appeals and grievances and check the status of your submission
  • Access a member's eligibility, benefits and more

How to get started:

If your practice already uses Availity, simply select Mercy Care from your list of payers to start or go to www.availity.com/MercyCareProviders.

If your practice is new to Availity, you can use this registration link to set up your account.

Need help registering or have technical issues? Call Availity at 1-800-282-4548 Monday-Friday, 8 a.m. to 8 p.m. (excluding holidays). 

Starting February 24, 2023, Mercy Care will no longer accept requests through our current provider portal. The current provider portal will officially be retired late 2023.

Our network

Mercy Care maintains a well-established network of physical and behavioral health providers. We remain committed to expanding services based on the needs of our members. If you’d like to join our network of providers, this page explains how. 

What we’re looking for 

Our recruitment efforts remain focused on both behavioral and physical health services that meet the unique needs of our members, including: 

  • Providers with a focused approach on LGBTQ services 
  • Provider with a focused approach on services for individuals with intellectual and developmental disabilities (I/DD)
  • Services in languages other than English 
  • Services that meet the unique cultural needs of our members 
  • Specific specialty services in rural parts of the state, like behavioral health outpatient services and cardiology services for children and adults

Letter of Interest process 

Here you’ll find the process for submitting your Letter of Interest for consideration as a network provider. 

You can request to join the Mercy Care network by submitting a Letter of Interest (LOI) and completing a W-9 Form (PDF).   

What to include in the LOI 

  • Provider specialty — any specialty services that you provide 
  • Geographic area(s) you serve 
  • Medicare ID number (if applicable)   
  • Arizona Health Care Cost Containment System (AHCCCS) ID number: all providers must have completed AHCCCS ID Provider Enrollment; call the Provider Assistance Unit if you need help at 602-417-7670, option 5  
  • A summary description of programs 
  • Target populations and specific age categories  
  • Specific models of care and therapies you use  
  • Frequency of programming treatment  
  • Appointment availability

Submit a completed request to Network Management. Make sure your request includes all the information on the LOI list. If anything is missing, you’ll have to resubmit a complete LOI and W-9.

If we deny your request for network participation, you can reapply in one year. We evaluate our network regularly. We’ll contact you directly if our needs change. 

If we approve your request to join the network, we’ll contact you to start the contracting process.

 

If we approve your network participation 

An onboarding specialist will contact you to get the credentialing form we require for your provider type.   

If you’re a practitioner, provide your updated Council for Affordable Quality Healthcare (CAQH) information. Be sure we can access your information. Otherwise, delays will result. 

A contract negotiator will send a Mercy Care Agreement for review and electronic signature.  

After we approve credentialing and you’ve completed and signed the Mercy Care Agreement, we’ll move forward with countersignature.

Before scheduling or seeing Mercy Care members 

Wait to schedule Mercy Care members until: 

  • We let you know your participation effective date 
  • You receive a copy of the fully executed Agreement 

Be ready to respond to requests from our network management team. If we don’t receive a timely response, we may deny your contract.  

Review your provider manual for more details.

Network Management serves our provider community. They train, maintain and strengthen our provider network while staying on top of all regulations.  

Network Management can: 

  • Do provider visits 
  • Train your staff on our policies and procedures 
  • Provide ongoing education resources 
  • Resolve operational issues to improve health care delivery 
  • Explain credentialing requirements 
  • Help you use tools like the secure provider portals  
  • Help with administrative functions, like claims submission (EDI), electronic funds transfer (EFT) and electronic remittance advice (ERA) 

Fax or email your updates:

You can also fax us at 1-860-975-3201 or email this information: 

  • Changes to your practice  
  • Tax ID changes 
  • Recent practice or provider updates 
  • Termination from practice 
  • Web portal registration form 

Contact your assigned Network Management representative

You can request copies of the member handbook. Just fill out the Mercy Care ACC Member Handbook Order Form and submit it to MercyCareNetworkManagement@MercyCareAZ.org. 

(Orders are processed on Fridays. Requests made on Thursdays after 5 p.m. will be processed the following week.)