Frequently Asked Questions
Should provider agency staff expect changes in their roles/jobs?
Mercy Maricopa is committed to working with provider agencies to ensure a member, provider and community driven system. Mercy Maricopa intends to continue the relationship with existing behavioral health provider agencies and values the role that case management, clinical, rehabilitation and other direct service staff play in the discovery and recovery journey of persons receiving services.
Mercy Maricopa will work with provider agencies to reduce the administrative burden of direct service staff while ensuring that more financial resources are available to increase the provision of recovery based services to peers and family members. Mercy Maricopa is committed to enhancing the system of care’s ability to respond to whole health needs through expanding educational and training opportunities and creating care coordination positions within the SMI clinics.
If you have concerns about your role or job, you should talk directly with your supervisor and/or administrators within your provider agency. Mercy Maricopa does not expect any major changes in existing roles/jobs. However, we do plan an eventual expansion of understanding and incorporating whole health goals, interventions and care coordination into the treatment of both physical and behavioral health concerns – something that many of you may already being doing and something that may create new job opportunities within your organization. Furthermore, we envision the treatment teams expanding to include both physical and behavioral health care providers working together and sharing information with one another.
What does provider staff need to know about Mercy Maricopa’s Health Information Technology Strategy?
Mercy Maricopa brings state-of-the-art technology to providers in order to share information and allow for provider-to-provider, provider-to-member, and cross-system information exchange. Mercy Maricopa has technology that creates the possibility for multiple providers and various IT systems to communicate – allowing provider staff access to pertinent health information from other providers across the health care system. Such technology provides the opportunity for provider agencies to participate in health information exchange while still using the systems and platforms they already have and are familiar with, and allows members to access their own information in mobile or non-mobile environments.
Health Information Exchange
Mercy Maricopa will implement a free, state-of-the-art health information exchange (HIE). This HIE will support communication between all members of the treatment team, allowing behavioral and physical health providers to securely share clinical information. Care providers will be able to see relevant health information whenever and wherever they need it. This will lower health care costs by reducing duplication of tests. It will also help assure safer patient care.
Point of Care and Care Coordination Solutions
Mercy Maricopa will implement innovative tools at the point of care to coordinate behavioral and physical health. Utilizing the HIE, these tools will support providers, clinical staff, Care Managers, Care Coordinators and Case Managers. These clinical workflow applications will include electronic sharing of integrated care plans accessible to the care team and providers, electronic referrals, and a unified central member chart.
Gaps in Care and Care Alert Solutions
Mercy Maricopa will transform clinical information into meaningful data that can influence care decisions and optimize members’ health outcomes. Mercy Maricopa will also use extensive medical and pharmacy claims data to generate a single integrated member record and will continuously monitor these records for opportunities to avoid risk and optimize member care. This comprehensive information will be translated into care alerts to be delivered across the HIE to providers and individuals receiving services.
Mobile Health Solutions
Mercy Maricopa will provide mobile and web-based health care platforms which will empower individuals and their families to make more informed health care decisions and improve health care delivery.
I am interested in contracting with Mercy Maricopa. How can I become a contracted provider?
All providers who are interested in contracting with Mercy Maricopa must fax a Letter of Interest (LOI) to Mercy Maricopa at 860-975-0841. The LOI should be on the provider’s letterhead and must include the following information:
- AHCCCS ID number
- NPI number
- Medicare ID number (if applicable)
- Geographic location
- Provider specialty and services/facility
Please submit the following forms with your LOI:
- W-9 Form
- AzAHP Facility Application
- AzAHP Practitioner Credentialing Form
- AzAHP Organizational Credentialing Form
Providers must complete the following steps to be eligible to participate in our network:
- Credentialing application must be submitted correctly and completely.
- Providers must be fully credentialed by Mercy Maricopa.
- New providers will be mailed a Participating Health Provider Agreement (contract). Providers joining an existing group must complete the applicable contract documents in order to be added to the existing contract.
- Providers must sign and return all contract documents.
- Upon completion of credentialing and full execution of contract documents, the provider will receive notice from Mercy Maricopa network development department with the effective date of participation, along with the fully executed contract (if it is a new contract).
What if I am currently contracted with Mercy Care Plan and want to also contract with Mercy Maricopa?
Contact your provider representative about the process. If you do not know the name of your provider representative, you can locate it on the Mercy Care Plan website at: http://www.mercycareplan.com/assets/pdf/Provider_Relations_Assignments_Updated_January_2014.pdf
What employment opportunities will be available at Mercy Maricopa?
Job openings will be posted on the Careers’ page of http://www.aetna.com/. We will fill a high-volume of positions summarized in the bulleted list below. All interested and qualified individuals are encouraged to apply. We believe in keeping jobs local and tapping into our local talent pool whenever possible.
• Provider relations
• Claims processing
• Clerical support
• Call center staff
• Care management and Care Coordination Clinical Staff
• Clinical, medical management, and utilization management leaders and team members
• Network/System of Care leaders and team members
• Community outreach and communications
• Information technology
• Member services
Effective April 1, 2014, Mercy Maricopa Integrated Care will serve as the Regional Behavioral Health Authority for Maricopa County. Funds for services will be provided through a contract with the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the Arizona Health Care Cost Containment System (AHCCCS).
Children’s System FAQs
Mercy Maricopa will contract directly with children’s providers, beginning Jan. 1, 2015. We’re enthusiastic about this new approach to service delivery within the children’s behavioral health system and its potential to significantly enhance access and choice, and more closely align services with the “Arizona Vision” and Arizona Twelve Principles.
Here are some Frequently Asked Questions to help explain the change and what’s ahead for the children’s system.