Mercy Care Regional Behavioral Health Authority (RBHA) 835 . Mercy Care RBHA . never use your own money to start a business; react const function parameters PA requirement results are valid as of today's date only. You can file an appeal by calling 602-586-1719 or 1-866-386-5794 (toll free). Login to your online account. We also use third-party cookies that help us analyze and understand how you use this website. Or, you can call the AHCCCS Clinical Resolution Unit at 602-364-4558. For adults, same services may be recommended and will be available to you after completing the entire assessment process. What if I dont agree with the outcome of the decision? Mercy Medical Center. 2022 Equity / Innovation / Quality / Inclusion / Accessibility / Transparency / Compassion / Integrity. Mercy Care ACC-RBHA. Provider Contact Name Telephone Number Email Address A complaint can be concerns about the kind of care you are getting, concerns about how your doctor or their staff treat you, and lack of respect for your rights. Your services will continue unless we find that to change or continue your services could be a serious threat to your health or safety or the health or safety of others. Mercy Care mobile application gives easy access to popular health care tools. Exception Detail, Svc Partner Detail - When the. It is important to note that balance billing members is prohibited under all Mercy Care health plans. Representatives are available 24 hours a day, 7 days a week. Page 2 of 40 . Adminco Inc. 3.1 star. By mail: Mercy Care ACC-RBHA 4500 E. Cotton Center Blvd. SMI. In most cases, yes. As always, don't hesitate to contact your, with any questions or comments. Under Mercy Care AHCCCS (Arizona Health Care Cost Containment System) is Arizona's Medicaid Managed Care Program. A person with an SMI determination may be identified as a person in need of Special Assistance when the person is unable to communicate or participate effectively due to cognitive or intellectual impairment, or other behavioral or medical conditions. If we do, we will notify you of this delay in writing. Welcome to Mercy Care RBHA (Formerly Mercy Maricopa Integrated Care). Please refer to section titled Appeals: Title 19/21 for process. 837 Claim Transactions: . This website uses cookies to improve your experience. Scheduling: (319) 861-7778. What if I do not agree with the outcome of the SMI appeal? The Office of Human Rights may designate a person to provide Special Assistance for you and be involved throughout key stages of treatment and services. Deaf or hard of hearing individuals may call the Arizona Relay Service at 711 or 1-800-367-8939 for help contacting AHCCCS. Just fill out the member handbook order f orm and submit it to MercyCareNetworkManagement@MercyCareAZ.org. Mercy Care RBHAWith the Mercy Care RBHA mobile application, you can get on demand access to the tools you need to stay h You can find all the iPhone iPad apps here. For doctor's billing assistance, please call (888) 696-3541 Monday-Friday from 8:00am-5:30pm or log onto: paymercyhealth.com Hospital Visits: For hospital related customer service questions or billing questions, please call 855-732-0138 RBHA provides an on-site pharmacy for individuals receiving services at RBHA. An expedited appeal is an appeal that needs to be reviewed urgently. AHCCCS conducted a virtual review of Mercy Care RBHA from June 21, 2021 through June 24, 2021. Providing mental health, intellectual disabilities, substance abuse and prevention services to the citizens of the City of Richmond. Pharmacy Prior Authorization phone number number: Mercy Care 1-800-624-3879; DCS CHP 1-833-711-0776. Mercy Care RBHA Customer Service 1-800-564-5465 www.mercycareaz.org Services and support for living well We care about you and your family. You must file your request for an administrative appeal within 30 days of receiving the written outcome of the SMI appeal. If you are a person determined to have a serious or chronic mental illness, you have legal rights under federal and state law. You can always file for yourself. NT XIX . To better serve those across the central Virginia region, RBHA works with and/or operates an array of programs to improve quality of life and access to appropriate services. If you have any questions or need help with this website, call Mercy Care ACC-RBHA Member Services at 602-586-1841 or 1-800-564-5465; ( TTY 711). Have a Seriously Mentally Ill designation. . If your appeal was expedited, you can ask for an expedited State Fair Hearing. Mercy Care Regional Behavioral Health Authority (RBHA), Valleywise Community Health Center Mesa. Diagnosed with depression, anxiety, mania or psychosis. Phoenix, AZ 85040 By phone: Mercy Care ACC-RBHA Member Services 24 hours a day, 7 days a week 602-586-1841 1-800-564-5465 (toll-free) Hearing impaired TTY/TDD 711 24-hour nurse line: 602-586-1841 or 1-800-564-5465 Media inquires Monica Alonzo Pharmacy Prior Authorization fax number: Mercy Care and DCS CHP 1-800-854-7614; Mercy Care Advantage 800-230-5544, CVS Caremark Pharmacy Helpdesk number: Mercy Care 1-855-548-5646; Mercy Care Advantage 1-855-539-4721; DCS CHP 1-800-509-6854, eviCore Healthcare performs utilization management services on behalf of Mercy Care for the following: Musculoskeletal (pain management), Radiology Management (includes advanced imaging such as CT, MRI, MRA, PET scans). You can find this, Chapter 100 - Mercy Care Provider Manual - General Terms, MC Chapter 14 - Billing Encounters and Claims, Mercy Care Network Management Representative. EDI Enrollment Instructions: . RBHA 107 South Fifth Street, Richmond, VA 23219 + 804-819-4000 Crisis Hotline If you are experiencing a crisis, please contact RBHA Emergency Services, + 804-819-4100 Social Media Facebook Instagram LinkedIn Phoenix, AZ 85040. LoginAsk is here to help you access Mercycare Login quickly and handle each specific case you encounter. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Out-of-State Toll Free: 1-800-523-0231 For Members. If you do not want to leave our website, please click the X. Mercy Care RHBA was given . You have one year from the event to file a grievance or request for investigation. You also have the right to ask for a State Fair Hearing when the internal appeals process has been exhausted, the decision remains adverse and the service is clinical in nature. vHealth (Thailand) Adminco Inc. vHealth (Dubai) Adminco Inc. Creating Healthy Communities One Person, One Family, One Community at a time. W How long will it take to process my SMI appeal? Mercy Care Operational Review . The three types of appeals are: We will send you a written Notice of Appeal Resolution within 30 days of receiving your appeal request. Mercy Care RBHA has 90 days to take action, although complaints are often handled sooner. 3.03 - Case Management Contact Guidelines 3.04 - Care Management Caseload Ratio Guidelines 3.05 - Intra-RBHA Clinic Transfers 3.06 - Provider Financial Reporting 3.07 - Provider Deliverables Mercycare Login will sometimes glitch and take you a long time to try different solutions. Dec. ember 2018 Provider Directory . Director of Nursing or Designee Phone Number: Date of Sign-off: Time (24-hour clock) of Sign-off: Exhibit 962-1 - 7 of 7 . A directory of free or 'almost free' services in Maricopa County ; AZ Warmline for Postpartum Support: 888-434-MOMS (6667) or azwarmline@gmail.com AZ Chapter of Postpartum Support. Mercy Care Services - Valleywise Health. MERCY CARE RBHA PROVIDER MANUAL PLAN SPECIFIC TERMS . If we do, we will notify you of this delay in writing. Mercy Care RBHA Member Services 602-586-1841 or 1-800-564-546 (TTY/TDD 711 ) 24 hours a day, 7 days a week Behavioral Health Crisis Line 602-222-9444 or 1-800-631-1314 , TTY/TDD: 1-800-327-9254 24 hours a day, 7 days a week Maricopa Peer Operated Warm Line Operated by trained peer counselors who have similar life experiences as you. . If you are experiencing a Behavioral Health Crisis, call 1-800-631-1314 or 602-222-9444. CLICK HERE to view RBHA's COVID-19 Operating Updates. As of mid-2022, Medicare covers the Dexcom G6 as well. What is an SMI grievance or request for investigation? 1/30/19 Mercy Care Corrective Action Plan Arnold v. Sarn Requirements ; . Box for 12 months after. Join our network An appeal is when you tell us that you do not agree with the decision that we made about your services. Data safety. Intake & Admissions Meet with a professional and receive a care plan. Download a copy English | Spanish. Of course, benefits vary by plan, so you'll need to check with yours. Mercy Care RBHA. Richmond Behavioral Health fearlessly champions the health, wellness, and recovery of the people and communities we serve. The following persons or representatives may file an appeal or request a State Fair Hearing regarding an adverse benefit determination: A Title 19/21-eligible person adversely affected by a Pre-Admission Screening and Resident Review (PASRR). Mercy Care RBHA will be replacing the current vendor, Change Healthcare (CHC), with Conduent for services related to the receipt and imaging of all paper claim and claim correspondence. Provider Directory. 100% None ; DS 3 ; Provider Services Representatives are . number of members assigned to each PCP. If we do, we will notify you of this delay in writing. Mercy Care RBHA P.O. Search results, as well as, authorization are not a guarantee of claim payment. A large array of private insurers in the United States cover Dexcom CGMs. Mercy Care RBHA 610591 ADV RX8822 CVS/Caremark 855-319-6295 Steward Health Choice Arizona (formerly Health Choice Integrated Care) We may extend the 30-day timeframe another 14 days to obtain more information. We may extend the timeframe to obtain more information. Within two days of receiving your appeal we will schedule a meeting with you and your authorized representative to discuss the appeal. When can I file a grievance or request for investigation? INVALID - CPT or HCPCS code entered was invalid, not found. This website uses cookies to improve your experience while you navigate through the website. Box #64835 Will No Longer Be Valid Starting January 14th, 2022. Page . If you or a loved one needs help coping with a behavioral or mental condition and receives Mercy Care RBHA benefits, were ready to get you on the road to recovery. Mercy Care ACC-RBHA - Click here for PA requirements. Mercy Care . AHCCCS Health Plans BIN PCN Group Number PBM Phone Number AHCCCS FFS 001553 AZM OptumRx 855-577-6310 AHCCCS FFS - Secondary to Commercial 001553 AZM OptumRx 855-577-6310 . ACC-RBHA - AHCCCS Title XIX behavioral and physical health services for members designated Seriously Mentally Ill (SMI). There are more than a dozen Region 4 programs in operation. Our clinics team of caring professionals consists of a psychiatrist, medical personnel, specialists and administrators. Who can file my appeal or expedited appeal? What if I do not agree with the outcome of the grievance? Pharmacy Prior Authorization phone number number: Mercy Care 1-800-624-3879; DCS CHP 1-833-711-0776. Best viewed in Microsoft Internet Explorer 6 and higher, resolution 1280x800. Mercy Care Advantage Plan 001 (HMO D-SNP) Page 7 Plan Number H5580-001 866 571-5781 ) Mercy Care Plan Pima Health System PINAL* Health Choice PHP/Community Connection SANTA CRUZ AHCCCS Care (113,621) MED (4,469) 810,442 76% SSA SSI Cash 82,230 8% AHCCCS. It is mandatory to procure user consent prior to running these cookies on your website. Update your phone number, email address and other important member details. RBHA employs more than 750 people in the Richmond area. Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Mercy Care Advantage - Medicare/Medicaid. Meet with a professional and receive a care plan. Please refer to section titled Complaints: Title 19/21 for process. Effective Dates: 7/01/16, 07/12/17 . Future changes to CPT or Healthcare Common Procedure Coding System (HCPCS) codes that require PA will be communicated by Mercy Care in writing. Become a member. Adult Services You can also appeal in writing by mailing your appeal to: Mercy Care RBHAAttn: Grievance and Appeals Department4755 S. 44th Place Phoenix, AZ 85040. If you are not able to do so, anyone can file a grievance or request for investigation on your behalf. Mercy Care and its providers are required to identify persons with an SMI determination who are in need of Special Assistance. Benefit Reference Documentsopens pdf in new window. If you are currently in a crisis situation, call 804-819-4100 immediately. We hire frequently so please check out our current employment opportunities. If you meet the guidelines for Special Assistance, the AHCCCS Office of Human Rights will be notified. Your services will continue unless we find that to change or continue your services could be a serious threat to your health or safety or the health or safety of others. Only persons with a serious mental illness (SMI) determination can use the SMI appeals process. All rights reserved. Phone 844-234-9831; Fax 262-241-7150. Mercy Care ACC-RBHA Claims Department. System (HCPCS) codes or a CPT group and select SEARCH. We will notify you in writing within 5 days that we have received your grievance or request for investigation. 1-888 -700 -6822 Hours: 24 hours a day , 7 days a week . list of CPT or HCPCS codes to only those requiring PA, please check the box labelled Include only CPT or HCPCS codes where PA is required?. (319) 398-6011. Mercy Care Customer Service 1-800-624-3879 www.mercycareaz.org Care 1st Health Plan . Please submit your prior authorization request directly to eviCore at. Tel: (08) 9442 3444 Email: marketing@mercycare.com.au If you are Non-Title 19/21 (AHCCCS) eligible and not determined to have serious mental illness, you may appeal actions or decisions related to decisions about behavioral health services you need that are available through Mercy Care RBHA. To determine if prior authorization (PA) is required, enter up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes or a CPT group and select SEARCH. Similar apps. 6025861841 or/ 18005645465 TTY/TDD/Personas con ProviderRelations@MercyCareAZ.org. The RBHA pharmacy is able to fill prescriptions for medical and psychiatric needs, allowing consumers easier access to needed medications. Updated on. We will notify you in writing within one day that we have received your request for an expedited appeal. GMHSU (General Mental Health & Substance Use) - Includes members who are Native Americans. Complete mercy care in several clicks by simply following the instructions below: Customer service hours of operation: Our updated mercy care claims processing manual is now available to assist you with any claims or billing questions you may have. For additional information regarding claim submissions, either electronically or through paper, please feel free to review the following resources: Both manuals will be updated with the new P.O. These cookies will be stored in your browser only with your consent. A key factor in getting claims processed in a timely manner is correct claims submission, and Mercy Care RBHA provides multiple options for you to choose from, including the sending of paper claims through the mail. Protect against COVID-19. An expedited appeal is an appeal that needs to be reviewed urgently. Existing statewide crisis telephone numbers will remain for at least one-year. Box 982976 El Paso, TX 79998-2975 Mail will be forwarded from the old P.O. We will notify you in writing withinfive days that we have received your request for an appeal. For Members. Whether its you or a family member who needs treatment, your Mercy Care RBHA benefitsgive you access to Valleywise Healths specialized behavioral and mental health services. An administrative appeal is when you tell AHCCCS that you do not agree with the outcome of your grievance investigation. How long will it take to process my expedited SMI appeal? Email to Mercy Care RBHA . How to Apply Covered Services Pay Your Premium Health Insurance for Children . Box 982976. If you are experiencing a Behavioral Health Crisis, call 1-800-631-1314 or 602-222-9444. A complaint is when you tell us that you are not happy with any or all of your care. . information regarding PA submission or service partner requirements. Dental benefits are administered by DentaQuest. But opting out of some of these cookies may affect your browsing experience. How long will it take to process my expedited appeal? Mercy Care 7 a.m. to 6 p.m. Monday through Friday 602-263-3000 or 1-800-624-3879 Hearing Impaired (TTY/TDD 711) 24-hour nurse line: 602-263-3000 or 1-800-624-3879 Mailing address: Mercy Care /Mercy Care Advantage 4500 E. Cotton Center Blvd. Sep 30, 2022. P.O. up to six Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding RBHA performs psychiatric evaluations and treatment for eligible individuals and provides a central point for medication access for consumers without an insurance prescription benefit. We specialize in co-occurring services and treatment to serve the whole child. We understand that children and families may have multiple needs and co-occurring behavioral health challenges that require a comprehensive approach to treatment and support. To check status of EDI enrollment, please contact Mercy Care at 800-624-3879 Express Code 631. . The change in vendor requires a change in the P.O. If you are Non-Title 19/21 (AHCCCS) eligible and not determined to have serious mental illness, you may file a complaint related to decisions about behavioral health services you need that are available through Mercy Care RBHA. If you go over that timeframe, we can still review your request for good cause. Box is live, mail must be sent to the following address: Mail will be forwarded from the old P.O. These rights include: If you would like information about your rights, you may request a copy of the "Your Rights in Arizona as a Person with a Serious Mental Illness (SMI)" brochure. Box Address and Vendor for Paper Claim and Claim Correspondence Effective 1/14/2022. How long will it take to process my appeal? The right to appropriate mental health services based on your individual needs, The right to participate in all phases of your mental health treatment, including individual service plan (ISP) meetings, The right to a discharge plan upon discharge from a hospital. 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