SSM Health Managed Care Organization
Established in 1994, the SSM Health Managed Care Organization (MCO) offers participating providers more than 45 managed care contracting opportunities within the St. Louis metro area. Its contracts include commercial products, workers’ compensation, behavioral medicine, Medicare HMOs and managed Medicaid products. Reimbursement is non-risk, fee-for-service, and some contracts do include primary care capitation.
More About SSM Health's MCO in St. Louis
The SSM Health MCO was designed to create an integrated and coordinated network of health care providers for participation in managed health care plans and to provide support services, such as delegated credentialing and re-credentialing that may be related to those plans. It also offers unique and distinctive managed health care products to purchasers, emphasizing the coordinated provision of appropriate medical services in a cost-effective manner.
SSM Health MCO’s corporate structure and support system enables continued growth in the insurance market. Its membership includes over 2,300 providers in the St. Louis area, including SSM Health Medical Group, SSM Health Rehabilitation Hospital, SSM Health Cardinal Glennon Children’s Hospital and independent community providers.
Why choose SSM Health's managed care organization
The SSM Health Managed Care Organization provides a number of opportunities and benefits. Below are just a few reasons to consider joining the SSM Health MCO.
- Opportunity to participate in a managed care organization that includes SSM Health hospitals and physicians, as well as access to more than 45 managed care contracts.
- Opportunity to serve in a leadership role in an experienced managed care organization
- Minimize paperwork! Membership in the SSM Health MCO can provide your organization access to many managed care contracts accepted at SSM Health in St. Louis hospitals
- Physicians with SSM Health board-approved medical staff privileges at an SSM Health in St. Louis hospital are eligible for membership in the SSM Health Managed Care Organization
Over 2,300 providers are currently participating in the SSM Health MCO. there is no application fee for the SSM Health MCO; however, annual dues are assessed each September. As a reference, annual dues were assessed at $250 per participating provider last year.
Insurance Accepted
This is a list of the major plan contracts in which SSM Health facilities participate. This list does not include every contract held by an SSM Health facility. This list is continually updated. Please confirm that we accept your insurance with your facility.
Apply to Join the MCO
Physicians with SSM board-approved medical staff privileges at an SSM Health St. Louis hospital are eligible for membership in the SSM Health Managed Care Organization.
Update MCO Demographic Information
All fields must be complete for any changes to be reported to health plans. Some health plans do not allow retroactive effective dates. Please report all demographic changes at least 30 days in advance.