American Indian Health Provider Resources


FAQs for the American Indian Health Program and ALTCS FFS

What is the American Indian Health Program (AIHP)?

The AHCCCS Acute Fee For Service Program for American Indians, administered by the State through the Division of Fee For Service Management at AHCCCS.

Who can treat AIHP members?

Any AHCCCS Registered Provider that has not opted out of fee for service. The AHCCCS FFS Program does not contract with individual providers.

How do you submit a claim for an American Indian?

If... Then...
If member is enrolled in AIHP and you are an AHCCCS FFS Provider (any AHCCCS Registered Provider that has not opted out of fee for service). Claims are submitted to AHCCCS/Division of Fee For Service Management (DFSM).
If member is enrolled with managed care or a program contractor and services are NOT provided at an IHS/Tribal 638 facility. Claims are submitted directly to the plan / program contractor.
If member is enrolled with managed care or a program contractor and services ARE provided at an IHS/Tribal 638 facility. Claims are submitted to AHCCCS/DFSM.
If member is receiving Behavioral Health services at an IHS/Tribal 638 facility. Claims are submitted to AHCCCS/DFSM.
If member’s Behavioral Health Services are NOT provided at an IHS/Tribal638 facility. Claims are submitted to the member’s RBHA or TRBHA.
If member receives Transportation and Case Management services for Behavioral Health, regardless of where the services were received. Claims are submitted to the member’s RBHA or TRBHA.

Submit your AHCCCS/DFSM claims online

AIHP members do not need referrals to see an AHCCCS registered provider.
Please use these links to Chapter 820 in the AMPM; Chapter 6 in the IHS/638 Provider Billing Manual; and Chapter 8 in the FFS Provider Manual.
Yes. Under federal law, American Indians may not be required to choose a managed care plan. Please use this link to sign in and verify eligibility online at the time of service. https://azweb.statemedicaid.us

AIHP, FES (Federal Emergency Services), Tribal ALTCS (including Gila River Indian Community, Hopi Tribe, Navajo Nation, Pascua Yaqui Tribe, San Carlos Apache Tribe, Tohono O’Odham Nation, White Mountain Apache Tribe, and Native American Community Health), and QMB Only. A QMB Only is a Non-AHCCCS Member who retains original Medicare coverage and has no AHCCCS health plan enrollment. The member opts out of “QMB Dual” coverage, and AHCCCS pays for coinsurance and deductible for Medicare.

For more information on ALTCS Tribal, please visit the ALTCS Tribal Case Management page.

If you have further questions, you may call AHCCCS Provider Services at (602) 417-7670 for specific billing and eligibility questions.