AHCCCS Reinsurance Resources

Reinsurance Resources are intended for health plans and program contractors under the Arizona Health Care Cost Containment System (AHCCCS) Acute Care and Arizona Long Term Care System (ALTCS) programs.

• Forms
  • Quarterly Transplant Log [Excel, 57KB]
  • Reinsurance Action Request Form [Word, 78KB]
  • Action Request Form Instructions [PDF, 14KB]
  • Reinsurance Case Creation Request [Word, 48KB]
  • Request for Catastrophic Reinsurance [Word, 28KB]
  • Request for Transplant Reinsurance [Word, 31KB]
  • Transplant Outlier Template [Excel, 36KB]
    • Transplant Outlier Template Instructions [PDF, 22KB]
• Transplant Stage Invoice Cover Sheet [Word, 70KB]
• Transplant Stage Submission Checklist [PDF, 32KB]
• Transplant Transportation Lodging Form [Word, 35KB]
• Guides & Manuals
  • Reinsurance Edit Resolution Document [PDF, 94KB]
  • Reinsurance Processing Manual Effective 10/01/2012 [PDF, 251KB]
  • Reinsurance Processing Manual Effective 10/01/2011 [PDF, 227KB]
  • Reinsurance Processing Manual Effective 01/01/2011 [PDF, 251KB]
  • Reinsurance Transplant Case Key Entry Instructions [PDF, 1.3MB]
  • Reinsurance Finance Prepaid Medical Management Information System (PMMIS) Training Manual [PDF, 10MB]
• Newsletters
  • Reinsurance Hot News