In the same manner that MHP asks that our providers submit accurate and valid information in their medical claims, MHP must maintain accurate and valid provider information in its provider database and claims system. The matching of provider submitted claims data to the provider information in MHP’s claims system is a critical component of quickly and correctly processing a provider’s claims.
It is critical that MHP has your current and accurate provider and billing information loaded in its claims system. Please confirm with your Provider Relations Representative that the following information is current in our system:
Provider Name (as noted on current W9 form);
National Provider Identifier - Type I, Individual NPI);
National Provider Identifier - Type 2, Group NPI) as applicable;
Physical address;
Billing name and address; and
Tax Identification Number (TIN).
MHP rejects claims if billing information submitted does not match the information currently in our system. A rejected claim results in delayed processing and is not considered a 'clean claim' for purposes of timely filing requirements.
A clean claim is a claim that is coded correctly and ready for adjudication without any additional information or documentation needed by Plan to process to completion.
MHP expects to be notified in advance of changes pertaining to billing information.
Maintaining an up-to-date W-9 form for MHP’s records complies with IRS regulations and ensures the correct delivery of your 1099 Form at year’s end.
W-9 forms are available on our website, mercyhealthplans.com. Please return the completed form to Provider Information Management at the following address:
Mercy Health Plans Provider Information Management
14528 S. Outer Forty Road, Suite 300
Chesterfield, MO 63017-5743
Providers may also fax updated forms to 314-214-8107 or 800-466-9854.