Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Thanks so much! Contracted providers can find reimbursement information in their Mercy Care contracts. endobj The claim dispute process should only be used after other attempts to resolve the matter have failed. 2 0 obj Electronic submission*: Through Electronic Clearing House, DentaQuest of Arizona, LLCAttention: Claims Department P. O. That's why we're working to strengthen it. You can obtain a copy of you Plan Document any time using the appropriate link below: If you belong to the ClaycoGroup Health Plan: If you belong to the Crystal Oaks Group Health Plan: If you belong to Hermann Area Hospital District Group Health Plan: If you belong to Integrity Home Care + HospiceGroup Health Plan: If you belong to Suntrup Group Health Plan: Tags:Mercy Top NewsFiles: 35409.jpgMedia Contact:Brad HallerShow EMS Sitewide:Yes!Widgets:Widget Text Mercy Doctors Get Blunt About At-Home Fireworks CopyWidget Video Mercy Doctors Get Blunt About At-Home Firewor Read the whole story , Plan Document Narrow Network (coming soon). Claims Mailing Address: Medical. What type of electronic capabilities does Mercy Care RBHA have? TBA Site Map: For Navigation, click here for the TBA Site Map. A claim dispute is a dispute involving the payment of a claim, denial of a claim, imposition of a sanction or reinsurance. We invite you to learn more about how our specialized programs and cutting-edge technology create measurable results including a healthier and happier workforce. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS APPLICABLE STATE Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 . (855) 757-6060 About UsNewsPricing Services ProvidersSoftware VendorsPayers Payer List Schedule Demo Schedule Demo We hope you enjoy our new look! Mercy Care Claims Department P. O. Providers - Send Claims to: Insurance Benefit Administrators c/o Zelis, Box 247, Alpharetta, GA, 30009-0247 How to Appeal an Adverse Benefit . For hospital inpatient claims, date of service means the date of . If you belong to theHermann Area Hospital DistrictGroup Health Plan,please call 844-841-3891. Click here to find additional providers and resources for: Prescription drug coverage: Prime Therapeutics; Vision Coverage: Davis Vision; Mental health/substance use disorders: Blue Cross Blue Shield of Illinois (BCBSIL) Employee Assistance Program: Beacon Health Options We would require a copy of their explanation of benefits. 1!@.r,`2 Contact Us. Mercy Benefit Administration Payer ID: 37264 This insurance is also known as: St Johns Claims Administration Need to submit transactions to this insurance carrier? Find another provider. "Jt-?mZ=uU+/ePB4h(O_. Electronic submission*: Through Electronic Clearing House Our updated Mercy Care Claims Processing Manualis now available to assist you with any claims or billing questions you may have. To update your address, phone number or email, call 1-855-432-7587 . For a guide to self-registering on member portal: click here. Check the status of a claim. endobj Written claim disputes must be submitted to the MC Appeals Department. Arizona state law and your Mercy Care provider contract prohibits balance billing MC members for Medicaid covered services and benefits. H"Z 0v0@7w IzuSPPk-ziEn,Y0d^NU&ZXMr}~=c*0:/L|sb%}M[i)`jUvqh)nxM { W>O}R? All State Fair Hearing Requests must be sent in writing to the follow address: Attention: Hearing Coordinator4500 E. Cotton Center Blvd.Phoenix, AZ 85040. The request for State Fair Hearing must be filed in writing no later than 30 days after receipt of the Notice of Decision. The trusted experts in benefits for government contractors, providing full-service third-party administration for fringe benefit plans and enabling hundreds of companies attain complete compliance under the Service Contract Act (SCA), Davis-Bacon Act (DBA), The AbilityOne Program (JWOD) and related legislation. A claim dispute is a dispute involving the payment of a claim, denial of a claim, imposition of a sanction or reinsurance. Please include all supporting documentation with the initial claim dispute submission. Mercy| 3265 S. National | Springfield, MO 65807 | 417-820-9108 Learn More Auxiant's Integrated Buy Down product integrates with a client's fully insured benefit plan as a way to decrease the premium but limit the cost to the employee. At 90 Degree Benefits, our clients know they have more than an administrator: they have a wealth of resources, knowledge and guidance at their . Not only do we now have the ability to receive disputes by fax, but we can also respond back to our providers via fax, allowing you to receive faster decisions. If the visit does not result in a COVID-19 test, or provides services unrelated to COVID-19 testing, cost-sharing and plan limitations may apply. Better Provider Options. Leave of Absence Administration. x]mo A@u+"EnIroE{?luc4;3v% _}YH=3p8|8ooyooyy"J*SWW_?|ze; Visit our home page for career opportunities and to view current press releases. Additionally, a Level Two report is provided to your vendor, which is the only accepted proof of timely filing for electronic claims. If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. We have main offices located in Chicago, St. Louis, and Fresno. We invite you to learn more about how our specialized programs and cutting-edge technology create measurable results including a healthier and happier workforce. QuikTrip Corporation Mercy Benefit Administrators (MBA) PO Box 211197 Eagan, MN 55121 Electronic Payor ID #43185 (918) 615-7972 MO IL . Box 982975El Paso, TX 79998-2975. Please clearly state State Fair Hearing Request on your correspondence. Insurance Benefit Administrators PO Box 2943 Shawnee Mission, KS 66201-1343 . Contracted providers can find reimbursement information in their Mercy Care contracts. The website information you will be accessing is provided by another organization or vendor. Send us an email or call 877-875-7700 KJ1^`qyKWnV69rK+0=rm4/zsx.x@U !w{d)jR]Ur{"dN HG4d'WDOvC_z4"z= d ~H?,^[J[|/\@9l*x-YFU"0K\OWopZ)uCD~n3tdga`-]%& >ZtjK E?2qf. "pn7? Contact the Employee Assistance Program toll-free at 1-877-254-0781, or learn more here. They can help answer any specific questions you may have around your doctor or hospital visit, address your individual service needs, and assist you in paying your bill. Who do I call if I have a claims question? Claims Mailing Address: Medical. Mercy is changing the healthcare experience for members, employers, and physicians. 210, Springfield, MO 65807. . Please clearly state State Fair Hearing Request on your correspondence. All electronic submissions shall be submitted in compliance with applicable law including HIPAA regulations and Mercy Care policies and procedures. MC may request an extension of up to 45 days, if necessary. Mercy Benefit Administrators, LLC is a Missouri Limited-Liability Company filed On September 26, 2014. If you do not want to leave our website, please click the X. FAX: 913-901-0534 ClientServices@insurancebenefitadministrators.com. Electronic submission*: Through Electronic Clearing House TRISTAR is a nationally recognized provider of quality, cost-effective benefits administration, including self-funded medical, integrated disability and absence management. This could result in the claim being denied for untimely filing. . Protect against COVID-19. Who are Mercy Care RBHA's electronic claim submission vendors? BAS currently administers employee benefit programs for over 700 employer groups, ranging in size from 25 to 16,000 employees. For a guide to self-registering on the claim status site: click here. RISK CONTROL. Box 982975 El Paso, TX 79998-2975. You may contact Mercy Care Management, Mercy Disease Management, and Mercy Utilization Management toll-free at 1-800-662-9962 and via fax at (417) 820-7271 or 1-855-250-2900. BAS employs over 500 knowledgeable employees with vast experience in the industry. Disability Claims Management. Our updated Mercy Care claims processing manualis now available to assist you with any claims or billing questions you may have. JKQmUC*9RV9B c S&Htc Mercy Care's electronic claim submission vendors. A provider may file a claim dispute based on: Before a provider initiates a claims dispute, the following needs to occur: o Within 12 months after the date of service. Benefits Include: You've been unbelievably helpful throughout this entire process, and I appreciate the high level of customer service. Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. If you do not want to leave our website, please click the X. Mercy Care Claims Department P. O. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. Contact the pre-notification line at 866-317-5273. MC may request an extension of up to 45 days, if necessary. |]~yyR >mloJ(;TpK Vqcl All State Fair Hearing Requests must be sent in writing to the follow address: Attention: Hearing Coordinator4500 E. Cotton Center Blvd.Phoenix, AZ 85040, Vendor: Southwestern Provider Services (SPSI). Box 982975 El Paso, TX 79998-2975. a) Claims must be legible and suitable for imaging and/or microfilming for permanent record retention. If a provider does not receive an acknowledgement letter within five (5) business days, the provider must contact the Appeals Department. If a provider disagrees with the MC Notice of Decision, the provider may request a State Fair Hearing. I had numerous questions, and your responses were detailed, clear, and patient. If a provider does not receive an acknowledgement letter within five (5) business days, the provider must contact the Appeals Department. 2022 TRISTAR Insurance Group | All Rights Reserved |. M&fvW?an3sY/3;\d_[}{SJsNw>QkG|vu(QE Mercy Care RBHA's timely filing limitations are as follows: New claim submissions: Claims must be filed on a valid claim form within 150 days from the date services were performed or from the date of eligibility posting, whichever is later, unless there is a contractual exception. { If you are submitting via mail, the claim dispute, including all supporting documentation, should be sent to: Mercy Care Grievance System Department4500 E. Cotton Center Blvd.Phoenix, AZ 85040. Please include all supporting documentation with the initial claim dispute submission. Box 2906Milwaukee, WI 53201-2906, Mercy Care FinanceP.O. Quickly access the information you need by clicking on a selection to the right after logging in. Per our contract, we follow lesser of language when we coordinate benefits. The request for State Fair Hearing must be filed in writing no later than 30 days after receipt of the Notice of Decision. Mercy Care ACC-RBHA is the payer of last resort. According to the Arizona Revised Statute, Arizona Administrative Code and AHCCCS guidelines, all claim disputes related to a claim for system covered services must be filed in writing and received by the administration or the prepaid capitated provider or program contractor. Contact us today for assistance. PRESS. Both full-time and part-time co-workers (working at least 48 hours per pay period) are eligible for a variety of benefits from day one. Contact your Network Management representative for more information about electronic billing. With 90 Degree Benefits, employers have choices: standard network design, direct facility contracts, concierge medicine, reference-based pricing and more. California Voluntary Plan Overview. Written claim disputes must be submitted to the MC Appeals Department. Complete ALL required fields, and include additional documentation when necessary. The following administrators will provide networks and customer service. Electronic billing ensures faster processing and payment of claims, eliminates the cost of sending paper claims, allows tracking of each claim sent and minimizes clerical data entry errors. Mercy Care is contracted with AHCCCS to provide Medicaid covered benefits and services to Mercy Caremembers. Medical claims can be sent to: Insurance Benefit Administrators, c/o Zelis, Box 247, Alpharetta, GA, 30009-0247; EDI Payor ID: 07689 You will be contacted by Insurance Benefit Administrators regarding final pricing for the claims submitted in the weeks following submission. <>/Metadata 271 0 R/ViewerPreferences 272 0 R>> Our staff will ensure you get the most from your health benefits. Workers' Compensation programs, property and casualty programs, loss prevention and safety services, bill review, medical case management and wellness programs, for workplace safety, risk control and ergonomics, MEDICAL DENTAL VISION ACCOUNT INFORMATION, MEDICAL DENTAL VISION STATUS REPORT AND MEMBER ELIGIBILITY. Instructions on how to fill out the claim forms can be found at the following AHCCCS website addresses: Submit original copies of claims electronically or through the mail (do NOT fax). . Claims Mailing Address: Medical. Group Health Benefits Administration. view the status of claims; view patient coverage; view and print off explanations of benefits ; Login to view the status of your claims. . YVR_gw":o -"W`U4k^u!I,1~?Z_]fN'{ ,E7.%?y2*T~^]ibzNRy5]~^]o_7tb(!ztX*B.zyxZ4:PrWwU^-/92oklVTxJo mo'jsrW_Wrus~R$0~rm^:j ZmQSr"L)5G3*_n`?]Wc|st9$~ Do you have timely filing submission rules? Box 90640Phoenix, AZ 85066. Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Using TRISTAR active management, the duration of their FMLA/STD leaves were reduced by 13%, and their absence days from 2011 to 2012 were reduced by 33%. A provider may file a claim dispute based on: Before a provider initiates a claims dispute, the following needs to occur: o Within 12 months after the date of service. <> If you choose to send via fax, please fax your disputes to 602 351-2300. Doctor Visits: For doctor's billing assistance, please call (888) 696-3541 Monday-Friday from 8:00am-5:30pm or log onto: paymercyhealth.com Hospital Visits: AHCCCS (Arizona Health Care Cost Containment System) is Arizonas Medicaid Managed Care Program. Have a Representative Contact You The claim dispute process should only be used after other attempts to resolve the matter have failed. . We invite you to learn more about how our specialized programs and o Or within 60 days after the date of the denial of a timely claim submission, whichever is later. Become a Mercy provider. In accordance with contractual obligations, claims for services provided to a Mercy Care RBHA member must be received in a timely manner. For additional information regarding your electronic tools, call your Provider Relations representative at 1-800-564-5465 (TDD/TTY) 711. Claim: Mercy Benefit Administrators is a Missouri Assumed Name filed On February 24, 2012. 4 0 obj 210, Springfield, MO 65807 and its mailing address is 3265 S. National Ave. ste. Find out More Find out More Full Payer List CLAIM.MD MANAGED CARE. MC will acknowledge a claim dispute request within five (5) business days after receipt. endobj b) Through the mail to the appropriate address: Additional information regarding claim submissions can be found in theProvider Manual. 1 0 obj If testing finds COVID-19 to be present, treatment of the complications will likely be subject to normal cost-sharing and network requirements.. adults and seniors eligible for AHCCCS benefits. Payer Information Mercy Benefit Administrators - Repricing Payer ID: 43185 Need to submit transactions to this insurance carrier? You may request a new ID card through our contact form. Provider Tax ID: Patient ID: Electronic Payer Identification Number; Change Health Care: XXX: Mailing Address; Merchants Benefit Administration, Inc. Claims: 109 E 17th Street Suite 5574: Cheyenne, WY 82011 . Select the appropriate claim form (refer to table below): Hospital inpatient, outpatient, skilled nursing and emergency room services, Dental services that are considered medical services (oral surgery, anesthesiology), Mercy Care Claims DepartmentP. O. Non-contracted providers can refer to the AHCCCS fee schedule for reimbursement information. To include supporting documentation, such as members medical records, clearly label and send to the Claims Department at the correct address. The Registered Agent on file for this company is Burke, James L. and is located at 1235 E. Cherokee St. Attn: Law Department, Springfield, MO 65804. QuikTrip Corporation Mercy Benefit Administrators (MBA) PO Box 211197 Eagan, MN 55121 Electronic Payor ID #43185 (918) 615-7972 . Non-contracted providers can refer to the AHCCCS fee schedule for reimbursement information. Providers who are contracted with Mercy Care can use electronic billing software. b) The claim form may be returned unprocessed (unaccepted) if illegible or poor quality copies are submitted or required documentation is missing. You can also print a temporary copy of your card: click here. For more information, click here. Thank you for your support with my disability claim. Not only do we now have the ability to receive disputes by fax, but we can also respond back to our providers via fax, allowing you to receive faster decisions. If you are submitting via mail, the claim dispute, including all supporting documentation, should be sent to: Mercy Care Grievance System Department4500 E. Cotton Center Blvd.Phoenix, AZ 85040. The provider should contact MC Claims and/or Network Management to seek additional information prior to initiating a claim dispute. The company's principal address is 3265 S. National Ave. Ste. You may submit your claim dispute in writing through the mail or send electronically to us through fax. For all Group Health Plans administered by Mercy Benefit Administrators, pre-authorization or pre-certification is required for the following: Please visit the Mercy Provider Directory or call us at 1-877-875-7700. Our broad network of providers offers services and . The provider must follow all applicable laws, policies and contractual requirements when filing. Click anywhere to close Payer Information Mercy Benefit Administrators - Repricing Payer ID: 43185 Need to submit transactions to this insurance carrier? Print an Explanation of Benefits (EOB). "The Families First Coronavirus Response Act requires private health plans (including insured, self-insured, and grandfathered, as defined in section 1251 (e) of the Patient Protection and Affordable Care Act)) and government . The provider should contact MC Claims and/or Network Management to seek additional information prior to initiating a claim dispute. Mercy Care RBHA's timely filing limitations are as follows: Failure to submit claims in a timely manner could result in your claim being denied for timely filing. Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 . TRISTAR designs self-funded benefit plans according to each client's specifications. 3 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 20 0 R 21 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> o Within 12 months after the date that eligibility is posted. A landing page to inform members of upcoming change to Mercy Care Plan. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. . SERVICES. You may submit your claim dispute in writing through the mail or send electronically to us through fax. Select your role Current Employers Prospective Employers Providers Patients and Members Authorize a service. A semiconductor equipment company in Silicon Valley has been a TRISTAR customer for 10 years. According to the Arizona Revised Statute, Arizona Administrative Code and AHCCCS guidelines, all claim disputes related to a claim for system covered services must be filed in writing and received by the administration or the prepaid capitated provider or program contractor: Contact your Provider Relations representative for more information about electronic billing. TRISTAR is a nationally recognized provider of quality, cost-effective benefits Mercy Care is contracted with AHCCCS to provide Medicaid covered benefits and services to Mercy Care members. Failure to specifically state the factual and legal basis may result in denial of the claim dispute. administration, including self-funded medical, integrated disability and absence management. TRISTAR is a nationally recognized provider of quality, cost-effective benefits administration, including self-funded medical, integrated disability and absence management. The website information you will be accessing is provided by another organization or vendor. If you belong to any other Group Health Plan administered by Mercy Benefit Administrators, please call 800-330-8305. (J4;Xf.^n5}uA hd5{w("M_[kz' Box 982975 . Find out More Mercy Benefit Administrators knows the importance of the patient-provider bond. To check the status of a claim or print and EOB: click here. The claim dispute must specifically state the factual and legal basis for the relief requested, along with copies of any supporting documentation, such as remittance advice(s), medical records or claims. Mercy's benefit program is designed to support your personal health and well-being, offer market-competitive coverage and fulfill our call to be responsible stewards of Mercy's resources. Please note, COVID-19 Vaccine scheduling is not available through the MyChart Help Desk. <> Once received, the claim dispute will be reviewed, and a decision will be rendered within 30 days after receipt. The Families First Coronavirus Response Act does not require group health plans or insurers to cover treatment for complications related to COVID-19. The company's filing status is listed as Active and its File Number is X01207097. o Within 12 months after the date that eligibility is posted. The provider must follow all applicable laws, policies and contractual requirements when filing. Mercy Benefit Administrators. Mercy Benefit Administrators Mercy Benefit Administrators has partnered with your employer to make your health coverage easier to understand and use. Insured . Login to your online account. Select your role Current Employers Prospective Employers Providers Patients and Members stream For current job listings, please go to the new TRISTAR Insurance Group site! The Families First Coronavirus Response Act requires private health plans (including insured, self-insured, and grandfathered, as defined in section 1251(e) of the Patient Protection and Affordable Care Act)) and government programs (including Medicare and Medicaid) to provide coverage for COVID-19 diagnostic testing and related services free of charge (without cost-sharing, such as deductibles, copayments, and coinsurance) to the public, through the end of the national COVID-19 emergency period. Get COVID-19 information and resources. Refer to our Provider Manual for more detailed information. cutting-edge technology create measurable results including a healthier and happier workforce. If you choose to send via fax, please fax your disputes to 602 351-2300. EMPLOYEE BENEFITS. Call our Claims Inquiry/Claims Research department at 800-564-5465 (TTY 711). If a claim is a resubmission or a corrected claim, please send to the above address, Attention: Resubmissions. . Ultimately your involvement made a difficult and stressful time in my family's life that much easier., employee at a Fortune 500 company in engineering & construction. The claim dispute must specifically state the factual and legal basis for the relief requested, along with copies of any supporting documentation, such as remittance advice(s), medical records or claims. Prior authorization or other medical management requirements for such services do not apply through the end of the national COVID-19 emergency period. 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