Mercy Care Provider Newsletter
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Mercy Care implements Provider Advisory Council
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Mercy Care kicked off a new Provider Advisory Council, and hosted its first meeting on March 6, 2019. The Council meets quarterly and has members from both the provider community and Mercy Care department representatives. The Provider Relations Department chairs the Provider Advisory Council.
The Provider Advisory Council’s goal is to solicit provider participation and feedback in order to improve our overall performance for our provider community. We’re asking providers for a one-year commitment to serve on the council, not to exceed a maximum of two years.
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Colorectal cancer screening initiative
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Mercy Care would like to partner with our primary care providers beginning in June 2019 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, haven’t 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.
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Contacting Provider Relations
Our Provider Relations Department is your touchstone to everything Mercy Care. We want to provide you with our most recent Provider Relations contact information in order to assist you with all your needs.
You can reach our Provider Relations department at 602-263-3000 or at 800-624-3879.
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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.
However, we continue to post all provider communications to our website.
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HonorHealth Addiction Medicine Fellowship Program
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In 2018, as a response to the overwhelming need for addiction services and for trained physicians to treat patients with substance abuse disorder, HonorHealth received accreditation to start the first addiction medicine fellowship in Arizona, in partnership with
Community Bridges, Inc.
In 2019, the fellowship will continue to train two fellows annually, with the next program start set for July 1, 2019. Applications are now being accepted at HonorHealth.com under the Addiction Medicine Fellowship program page.
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Online Provider Directory accuracy: Tell us about your changes
We recently sent a provider notification,
Online Provider Directory accuracy
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to providers as a reminder that Mercy Care must be contacted within 90 days in order to convey timely changes to the plan.
This includes the following general changes:
- Terminations
- Additions
- Demographic information
As a reminder, the provider manual is an extension of your contract. Mercy Care is audited by both of our regulators, CMS and AHCCCS, on the accuracy of information contained in our Provider Directory. Based on these audits, it has been determined that we aren’t receiving timely notice from many of our providers, reflecting poorly on our audit results to date.
Not notifying Mercy Care timely of these changes could result in financial ramifications.
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Confirmed measles case identified in Pima County
For additional information about measles, you can visit the Arizona Department of Health Services’ website at
azhealth.gov/measles
.
We will keep you updated with additional alerts we receive.
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Pima County providers
Mercy Care is proud to continue serving ALTCS, DDD and Mercy Care Advantage (MCA) members in Pima County.
Mercy Care is experiencing a high volume of inquiries from members in Pima County who are enrolled in
DDD, ALTCS and MCA
. These members are stating that their providers are informing them of contracting changes related to the AHCCCS Complete Care contract.
Note:
The 10/1 changes for the new AHCCCS Complete Care (ACC) program do not impact current DDD, ALTCS and MCA members in any GSA.
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Recent provider notifications
Mercy Care’s provider notifications contain important information for your use. You can click on the links for details:
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Upcoming events
Mercy Care’s Events section provides information regarding current events, including training opportunities:
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Recent Reference Material and Guides
Mercy Care’s
Reference Materials and Guides section contains valuable information you can refer to at any time:
There are
no updates
to our Reference Materials and Guides since our last newsletter.
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Mercy Care Advantage would like your help in caring for our older adults
How can you help?
By being compliant with both of the following:
- Care for Older Adults HEDIS Measure
- Annual Wellness Visits for members
What is the Care for Older Adults HEDIS Measure?
Members age 66 and older who annually have each of the four measurement requirements addressed:
- Medication review: Required component of Annual Wellness Visit
- Functional status assessment: Required component of Annual Wellness Visit
- Pain screening: Integral component of evaluation and management of patient visit
- Advanced care planning: Required component for Initial Preventative Physical Examination (IPPE) AND optional reimbursable component of the Annual Wellness Visit
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Why should my Rheumatoid Arthritis patient consider a DMARD?
Disease-Modifying Anti-Rheumatic Drugs (DMARDS) are a class of medications used to treat Rheumatoid Arthritis (RA). Mercy Care Advantage wants to ensure that all our members with a diagnosis of RA and no contraindications are taking a DMARD.
While many of our members find relief from the pain of RA through NSAID treatment, the standard is to utilize DMARD therapy as these drugs work to slow the progression of this disease and protect joints from permanent damage.
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Mini “Pii” sessions
Pii is hosting mini “Pii” sessions – Opportunities for all community providers to share ‘slices of information’
These WebEx sessions occur on Wednesdays for 45 minutes and the main ingredient will be you!
These sessions allow the sharing of experiences from practices that have been participating in our Practice Transformation Network and building of collaboration among the community of practice that is supported by Mercy Care throughout Arizona.
Types of mini “Pii” sessions include same day appointment planning, standing orders, recurring visits, the health information exchange (HIE), shared care plan communications, patient and family engagement and other topics to be identified.
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Meet Marisue Smith
Mercy Care's Network Relations Manager
Marisue has been with Mercy Care since March 2016. She started her career with Mercy Care as a Provider Relations Representative for PCPs.
Today, Marisue’ s role is focused primarily around project management, process improvement initiatives for Provider Relations, regulatory audits, working on RFPs, contract integrations and staff training.
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