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Submit the Mercy PHI access or authorization form to the local Health Information Management office.

Help applying for Medicaid and questions about ability to pay / financial assistance.

Mercy (Chesterfield/St. Louis-based system serving MO, AR, KS, OK) hospital and clinic bills, payment plans and remaining balances after financial assistance.

Inpatient behavioral health PA requests for Mercy Care ACC-RBHA members with SMI.

Claims Investigation/Claims Research for claim questions and overpaid claims; search claims in the Provider Portal first. Refunds go to the Finance address.

Mercy Care dental claims are administered by Liberty Dental Plan; electronic submission through Liberty's clearinghouse.

ECHO handles Mercy Care provider payments/ERAs (virtual card, ACH). For payment/ERA delivery questions, not claim adjudication.

Fax the PA request form with supporting materials for Mercy Care Medicaid plans and Mercy Care Advantage outpatient requests; ACC-RBHA SMI behavioral health outpatient requests use the same fax. Routine decisions within 7 calendar days per the page.

Provider line for Mercy Care ACC-RBHA members with a serious mental illness (SMI) designation; local 602-586-1841, TTY 711. Eligibility and benefits also via the provider portal or IVR. Not for Mercy Care Complete Care/LTC/DD (separate line).

Alternate local number: 602-263-3000. The contact page displays a June 18, 2024 update date and remains linked by the current provider home page updated October 14, 2026. Neither date is replaced by the retrieval date.

Provider line for Mercy Care Advantage dual-eligible special needs plan members; local 602-586-1730, TTY 711. Mailing address for letters: Mercy Care/Mercy Care Advantage, 4750 S. 44th Place, Ste. 150, Phoenix, AZ 85040.

Provider line for Mercy Care DCS Comprehensive Health Plan members; local 602-212-4983, TTY 711.

ACC-RBHA medical claims; electronic clearinghouse Payer ID 33628. Resubmissions: same box, Attention: Resubmissions.

Claims Mail To table in the July 2026 provider manual Chapter 100: Complete Care and Long Term Care medical claims; electronic clearinghouse Payer ID 86052. Resubmissions go to the same box, Attention: Resubmissions.

Claim disputes after other attempts at resolution have failed; fax is the preferred method. Include all supporting documentation.

CMS ACO ID A2616. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

CMS ACO ID A2097. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

CMS ACO ID A1215. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

Local program contact published by Trinity Health PACE for current participants, family members and people exploring services. Confirm residence ZIP/service area and screening requirements; the center name does not establish all-county coverage. Source page marks last update November 2025; contact page reviewed October 22, 2026.

CMS ACO ID A4649. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

Genesis (Davenport/Quad Cities) billing.

MercyOne bills (MercyOne Genesis patients use 563-421-3408).

Program screening and financial assistance for Des Moines/West Des Moines (same number published for Centerville and Newton; out-of-state area code as published).

Dubuque financial assistance (alternate 563-589-9066).

North Iowa financial assistance (alternate 641-428-7824).

Northeast Iowa financial assistance; toll-free 1-800-728-0159 also listed.

Physicians/providers only; also takes reports from clinics and LTC facilities sending patients to the ED. Toll-free published as 877-88-MERCY.

CMS ACO ID A3380. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

State directory read as a structured dataset. Named staff emails and emergency/police after-hours routes omitted. This is a local administrative route, not a medical emergency service.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. The Appeal Request Form (mandatory) says to return it to the Meritain Health Appeals Department at this P.O. Box, and also says information can be sent to the address on the EOB or other correspondence. Types: medical, dental, vision. No appeals phone is published on the form.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. Meritain's medical claim form says to send claims to this P.O. Box or fax. Form is the Texas version; plan-specific claim addresses on the member's ID card or EOB take precedence.

Meritain's vendor list shows Availity for claims submission. Number is Availity's, not Meritain's. Other listed vendors: Optum (formerly Change Healthcare) 866.817.3813 for eligibility, claim status and claims; Change Healthcare Dental 877.469.3263; SSI (ClaimsNet) 800.356.0092. Companion guides are linked on the page. No Meritain payer ID is published on this page.

Optum is listed by Meritain for eligibility, claim status inquiry and claims submission. Number is Optum's, not Meritain's. Dental option via Change Healthcare Dental is on the same page.

For predetermination of coverage only, not preauthorization/precertification. Use the Predetermination Request Form on top; verify eligibility first; fax each patient separately; mail photos rather than fax. Predetermination is not a guarantee of payment.

Meritain online provider portal for patient eligibility, claims information and forms; Appeal request form, Medical claim form and clearinghouse vendor list are linked from the page.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. The provider services page says to call this number for 24-hour automated phone benefits and claims information. For precertification and other inquiries the provider portal page says Customer Support is reached by phone but does not print a number: use the number on the member ID card.

The claim form prints 1.800.925.2272 under 'Status and benefit information'. Meritain's contact page (last fetched showing a maintenance notice) lists the same number for members who need an ID card or EOB copy. Prefer the provider number on the member ID card for plan-specific eligibility.

For the HealthCare Transition of Care Request Form (continued coverage with an out-of-network treating provider). Questions: call the Member Services number on the ID card. Not for claims or precert.

Published county department contact in the Georgia DPH county directory, District 4-0. County association follows the named directory record; it does not establish every program's eligibility or service area. The directory may publish a shared regional number. Confirm the office and purpose when connected. The listed fax has no specialized claims or medical-records submission purpose stated.

Published site contact in the Georgia DPH county directory, District 4-0. County association follows the named directory record; it does not establish every program's eligibility or service area. The directory may publish a shared regional number. Confirm the office and purpose when connected. The listed fax has no specialized claims or medical-records submission purpose stated. Site purpose as printed: Manchester Health Center.

Maine CDC official local-health-officer directory. Department contact number is reproduced without staff names or personal email addresses. State page provides no record update date, office address, fax or public mailbox. Read only; telephone reachability not tested.

CDPHE county directory main administrative referral. Published street location is an office, not a guarantee of every service there. Source page shows no publication date.