Electronic Data Interchange (EDI) Technical Documents

AHCCCS Companion Guides are intended to be a technical document describing the specific technical and procedural requirements for interfaces between AHCCCS and its trading partners and are not intended to repeat or take the place of specific information as contained in the TR3 for each transaction..

Note: Information provided in PDF files.

• 270/271 Batch Eligibility Request and Response Companion Guide
  • 4010a (note: obsolete 1/1/2012)
  • 5010a
    
    
• 276/277 Batch Eligibility Request and Response Companion Guide
  • 5010
    
    
• 277 Unsolicited Encounter Status Companion Guide
  • 4010a
  
  
• 278 Health Care Services Review – Request for Review and Response Companion Guide
  • 5010 [Under Construction]
    
    
• 834/820 Enrollment and Capitation Companion Guide
  • 4010a (note: obsolete 10/1/2011)
  • 5010 (note: obsolete 10/1/2011)
  • 5010a
    
    
• 835 Claim Remittance Advice Companion Guide
  • 4010a (note: obsolete 4/1/2012)
  • 5010 [Under Construction]
    
    
• 837 Fee for Service Claims Companion Guide
  • 4010a (note: obsolete 1/1/2012)
  • 5010a
    
    
• 837 Encounter Companion Guide
  • 4010a (note: obsolete 7/1/2012)
  • 5010a
    
    
• NCPDP 5.1 Encounter Companion Guide (note: obsolete 7/1/2012)
  
  
• NCPDP Post Adjudicated History Transaction Companion Guide [Under Construction]

Contact

For EDI inquiries, roster issues, or to become an AHCCCS Trading Partner, please email us at: EDICustomerSupport@azahcccs.gov