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Mercy Care Claims Processing Manual

Visit: Care Claims Processing ManualMERCY CARE Claims Processing Manual GENERAL Claims /BILLING GUIDELINES FOR ALL PLANS Mercy Care Claims Processing Manual Page 1 of 124 Last Update: October 2019 Proprietary TABLE OF CONTENTS All new changes to the Claims Processing Manual will be highlighted in yellow for your convenience. CHAPTER 1 GENERAL Claims Processing INFORMATION MC Website Claims Mailing Addresses, Electronic Vendors and Contact Information Form Types and Instructions 1500 (02-12) Form Completion Instructions UB-04 (CMS-1450) Form Completion Instructions Electronic Tools and Mercy Care Web Portal Clean claim Definition Regulatory Turnaround Times Interest Payments Prompt Payment Discount Timely Filing National Correct Coding Initiative Resubmission Process - Recoupment Process Overpayments Medical Necessity Reviews claim Disputes Mercy CARE Claims Processing Manual GENERAL Claims /BILLING GUIDELINES FOR ALL PLANS Mercy Care Claims Processing Manual Page 2 of 124 L

All new changes to the Claims Processing Manual will be highlighted in yellow for your convenience. CHAPTER 1 – GENERAL CLAIMS PROCESSING INFORMATION . 1.0 – MC Website . 1.1 – Claims Mailing Addresses, Electronic Vendors and Contact Information . 1.2 – Form Types and Instructions. 1500 (02-12) Form Completion Instructions

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