Join our network
We are committed to providing quality health care services to our members. And our credentialing and contracting processes help us achieve that goal.
To be eligible to join the Mercy Care Plan and Mercy Care Advantage networks as a provider, you must do the following:
- Correctly and completely submit the credentialing application
- Be fully credentialed by Mercy Care Plan or Mercy Care Advantage
- New providers will receive a Participating Health Provider Agreement (contract). Providers joining an existing group must complete the applicable contract documents to be added to the existing contract.
- Sign and return all contract documents.
- Upon completion of credentialing and full execution of contract documents, the provider will receive notice from the Mercy Care Network Development department with the effective date of participation, along with the fully executed contract (if it is a new contract).
Providers should not schedule or see Mercy Care members until they are notified of the participation effective date.
If you have questions about the process, contact your Provider Relations representative at 602-263-3000.
If you are interested in contracting with Mercy Care Plan or Mercy Care Advantage, you must complete the following steps and return appropriate listed application documents:
A Letter of Interest (LOI) should be faxed to Mercy Care at 1-860-975-3201. The LOI should be on the provider’s letterhead and must include the following:
- AHCCCS ID 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