We strive to make information readily available to your office. We understand that your office is affected by any changes to the contracts that you hold through Mercy Managed Care. In efforts to keep you updated, this section is designed to update you on contract information including: new contracts, contract terminations, rate updates, TPA changes, and miscellaneous other news.

Please be aware that not all rate changes or contract updates below will necessarily pertain to everyone. We are also not able to publish specific rate information online as that data is confidential. Please see the additional resources below that are available to you to confirm specific contract participation.

  • Mercy Network LLC providers: If you are participating with Mercy via a contract with Mercy Network LLC (this would include providers in Southwest Missouri,  Northwest Arkansas, Oklahoma and select providers in St. Louis), please reference your online matrix for specific contract participation.
  • Mercy PHO providers: If you are contracted with Mercy via the Mercy PHO (this would include the majority of providers in the St. Louis region), please reference your PHO contract and enrollment packet for a listing of the contracts you hold through Mercy.
  • Mercy employed/integrated providers in the St. Louis region: Please continue to reference the Managed Care hub on Baggot Street, and the Sharepoint site as your reference for contract participation.
  • All other Mercy employed/integrated providers: Please continue to use the Managed Care hub on Baggot Street as your reference for contract participation.

Provider Changes
As a contracted provider, it is important to notify us immediately of changes to your practice such as: a new provider joining the practice, changes in billing information, provider leaving the practice, or adding a new clinic location.  Notification may help avoid claim denials.  Please submit changes by fax 417-820-3821 or email. Please include a W-9 Form if the change involves a new billing address or tax identification number.

Cigna – Sleep Diagnostic Management Services

April 01, 2020

Please review the attached announcement from Cigna regarding an upcoming change in the authorization process for sleep studies.

Cigna has announced that effective February, 1, 2021, they have chosen eviCore Healthcare to provide the sleep diagnostic management services for Cigna customers.  Currently, this process is being handled by CareCentrix.  CareCentrix will continue to handle all authorizations up until the time the process transitions to eviCore next February.

Cigna – Sleep Diagnostic Management Services

 

Aetna – COVID-19: Taking Action Update 032520

March 25, 2020

Please review the following updated information from Aetna regarding their response to the COVID-19 outbreak.

Aetna – COVID-19 Taking Action 032520

Aetna – COVID-19: Taking Action

March 18, 2020

Please review the following provider update from Aetna regarding their response to the COVID-19 outbreak.

Aetna – COVID19 Taking Action

Cigna Reimbursement Policy Update – May 18, 2020

March 09, 2020

Please review the attached reimbursement policy update from Cigna regarding tests that comprise a nucleic acid sexually transmitted disease laboratory panel.  Effective May 18, 2020, Cigna will rebundle the CPT codes used to bill for individual tests into a single panel code.

Cigna – Reimbursement Policy for Nucleic Acid STD Laboratory Panel – 051820

Aetna OfficeLink Updates – March 2020

March 04, 2020

Aetna Office Link Updates – March 2020

Aetna has published the following correction to an article in their March 2020 newsletter.

Dear health care partners,

It has come to our attention that in the March 2020 edition of OfficeLink UpdatesTM the article titled Individual service codes and service grouping updates contained typographical errors for two categories. To remove any confusion this may cause, we updated the detail information for the following four CPT codes:

  • For CPT codes 63266, 63267 and 63268, the detailed description shows Ambulatory Surgery – Aetna Enhanced Grouper and the category number incorrectly stated 6. The updated category 5 now accurately coincides with the AEG assignment 5.
  • For CPT code 22634, the detailed description shows the Ambulatory Surgery – Aetna Enhanced Grouper and the category number incorrectly stated 5. The updated category 1 now accurately coincides with the AEG assignment 1.

The changes are reflected in the updated OfficeLink UpdatesTM (OLU) newsletter on Aetna.com for more information.

We apologize for any inconvenience and appreciate your understanding.

With kind regards,
Aurelie C. Steere

Editor, OfficeLink Updates