In alignment with the 10/01/2018 deployment of the ACCs, AHCCCS has consolidated the Site ID (54) and Health Plan ID (010306) values for both Mercy Care and Mercy Care RBHA. In order to distinguish between Integrated and Non-Integrated Title members with SMI it is necessary to review the Contract Type detail on the member’s Medical Enrollment. A contract type value of C (Acute SMI), D (Acute SMI PPC), or W (SMI KC) on RP 160 indicates the member has both physical and behavioral health coverage through a RBHA.
ACC/SMI/RBHA Contractors:
- Current Mercy RBHA and Mercy Care
- Health plan id 010795, site code 77 - contract types A, H - integrated SMI Plan
- Health plan id 010789, site code 37 - contract types K, V - RBHA functions
- Health plan id 010306, site code 54 - contract types A, H, Y, N - acute plan
10/1/2018 Single health plan id and site code - Mercy Care:
- Health plan id 010306, site code 54
- SMI Integrated Members - three new contract types C (acute SMI), D (acute SMI PPC) and W (SMI KC)
- RBHA Only Functions - Contract types K (behavioral health), V (KC behavioral health)
- ACC Plan - Contract types A (acute), H (acute PPC), Y (KC), N (Non Pay)
A Site ID value of 37 indicates behavioral health coverage with Mercy Care RBHA (aka Mercy Maricopa prior to 10/1/18) in the Non-Title program.
CMS 1500 (02/12) VENDORS
For your convenience, attached is a listing of our
EDI Vendors
that are currently listed in Mercy Care Claims Processing Manual.
As always, don't hesitate to contact your Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices posted on our
website
.
Thanks for all you do!
