Providers can also submit their request by calling Aetna directly (refer to the back of the member’s ID cards for the correct telephone number). Providers may submit their request electronically though our provider portal on Availity or their preferred EDI vendor using the existing Precertification Request transaction. The SNFs will be required to notify Aetna of admissions within 48 hours.Initial Precertification/Prior Authorization for admission from acute care hospitals to Skilled Nursing Facilities (SNF) are waived for all Commercial and Medicare Advantage (MA) Part C plans.Skilled Nursing Facility admissions from Acute Hospitals Search NewsĢ017 HealthChoice Provider Network News – December 2022įor all states, Aetna is temporarily applying the following changes, effective through January 31, 2023: Please include a W-9 Form if the change involves a new billing address or tax identification number. Please submit changes by fax 41 or email. Notification may help avoid claim denials. All other Mercy employed/integrated providers: Please continue to use the Managed Care hub on Baggot Street as your reference for contract participation.Īs 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.Louis region: Please continue to reference the Managed Care hub on Baggot Street, and the Sharepoint site as your reference for contract participation. Mercy employed/integrated 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 PHO providers: If you are contracted with Mercy via the Mercy PHO (this would include the majority of providers in the St.Louis), please reference your online matrix for 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.Please see the additional resources below that are available to you to confirm specific contract participation. We are also not able to publish specific rate information online as that data is confidential. Please be aware that not all rate changes or contract updates below will necessarily pertain to everyone. 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. We understand that your office is affected by any changes to the contracts that you hold through Mercy Managed Care. We strive to make information readily available to your office.
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