AHCCCS Plans, Providers, Contractors & Vendors

Here, you can find information about how to register as a provider, verify member eligibility and enrollment status, submit claims, and obtain manuals, guides, and forms.


Independent Contractor Workgroup:

AHCCCS has formed a workgroup to establish standards for an Independent Contractor model for the provision of in-home services to ALTCS members. The workgroup meeting dates and materials are provided below. Please note: The workgroup membership has been established. That said, AHCCCS welcomes inquires and/or input from individuals outside of the workgroup. Inquiries and input may be addressed to Dara Johnson. Stay tuned for updates on the progress of the workgroup.


Meeting Date Reference Materials
04/30/15 Agenda Meeting Materials Discussion Summary Notes
06/17/15 Agenda Meeting Materials  

 

FFS Provider Claim Submission:

If you have submitted a claim and want to check the status, you may do so using the AHCCCS on-line tool. If your claim is showing as pending please do not resubmit a claim to the AHCCCS Administration, claim resubmissions create additional staff resources and can cause a delay in payment.


AHCCCS Provider Survey – Claims

AHCCCS is conducting this survey to ascertain providers’ level of satisfaction with Claims Processing and Resolution by its contracted Health Plans. Your feedback is very important to our assessment and processes for improvement. Please take a few minutes to complete this brief survey and be sure to indicate if you are contracted with each listed Plan. Thank you in advance for your valuable feedback.

This survey has been closed. Results will be posted once AHCCCS has completed its review.
AHCCCS Provider Survey – Claims (Closed 12/04/2014)

Visit HEAPlus* to learn more about becoming a Community Partner!

*HEAPlus is Arizona’s online application. As a Community Partner you can provide application assistance to your customers, receive real-time electronic verification of many eligibility factors, track application status and more!


 

AHCCCS Transition to Inpatient DRG Payments

AHCCCS has contracted with Navigant Consulting http://www.navigant.com/ to provide assistance in analyzing the impact of, and potentially acquiring and implementing, a DRG-based inpatient hospital payment system. More information can be found on the AHCCCS Transition to DRG-based Payment web page.


 

Hospital Transparency Workgroup

As a result of a January 2014 report to the Legislature on hospital price transparency, AHCCCS and the Arizona Department of Health Services established a workgroup of hospital representatives. The Hospital Transparency Workgroup will discuss ways to improve the availability of hospital price and quality information in a format that is useful to consumers. Findings of this workgroup will be included in a January 2015 report to the Governor and Legislature.


 

AzAHP Credentialing Alliance

The Arizona Association of Health Plans (AzAHP), representing the organizations that contract with AHCCCS to provide for the health care needs of Arizona’s Medicaid members, is pleased to announce the creation of a new Credentialing Alliance aimed at making the credentialing and recredentialing process easier for our providers by eliminating duplication of efforts and reducing administrative burdens. Before the launch of the Alliance, practitioners who contract with the various AHCCCS health plans needed to have their credentials established and refreshed with each individual health plan in a costly and duplicative process. Today, through the entrepreneurial efforts of AzAHP, it’s now a one stop credentialing shop for those in our networks. Additional information regarding the new AzHHP Credentialing Alliance may be found in the provider notification below.
Provider Notification [PDF]


 

AHCCCS Managed Care Organization Update Meeting


Meetings will be held at AHCCCS (701 E Jefferson, Gold Room, Phoenix, Arizona) from 9:30 a.m. - 12:00 p.m. on the following dates:


 

AHCCCS Transition to ICD10

AHCCCS will be working on a transition to the ICD10 code set effective for outpatient/professional dates of service and Inpatient dates of discharge 10/1/2014 and after. More information can be found on the AHCCCS ICD10 Consortium web page. http://www.azahcccs.gov/commercial/EDIresources/ICD10.aspx



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