Get the free Mercy Care Behavioral Health Prior Authorization Request. Accessible PDF
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Mercy Care Behavioral Health Prior Authorization Request Fax: 8444243976 Telephone: 6022633000 TTY 711 Instructions for Submitting Behavioral Health Prior Authorization Requests Visit our Pro PAT
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How to fill out mercy care behavioral health
How to fill out mercy care behavioral health
01
Obtain a Mercy Care Behavioral Health enrollment form from the Mercy Care website or office.
02
Fill out the form with your personal information, including name, address, contact information, and insurance details.
03
Provide information about your behavioral health needs, such as any diagnoses, current providers, and medications being taken.
04
Submit the completed form to Mercy Care either online, by mail, or in person at their office.
Who needs mercy care behavioral health?
01
Individuals who are seeking mental health and substance abuse services.
02
Those with behavioral health conditions such as depression, anxiety, schizophrenia, addiction, or other similar disorders.
03
People who are looking for affordable and accessible behavioral health care in the Mercy Care network.
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What is mercy care behavioral health?
Mercy Care Behavioral Health is a managed care organization that provides mental health and substance abuse services to members in Arizona.
Who is required to file mercy care behavioral health?
Healthcare providers and facilities that are contracted with Mercy Care Behavioral Health are required to file claims with the organization.
How to fill out mercy care behavioral health?
Providers must submit claims electronically or by mail using the required forms and documentation specified by Mercy Care Behavioral Health.
What is the purpose of mercy care behavioral health?
The purpose of Mercy Care Behavioral Health is to ensure that members have access to necessary mental health and substance abuse services and treatment.
What information must be reported on mercy care behavioral health?
Providers must report the member's diagnosis, treatment provided, dates of service, and any other relevant information required by Mercy Care Behavioral Health.
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