AHCCCS Claims Clues

The DFSM Claims Clues is a monthly newsletter produced by the AHCCCS Claims Department for Fee-For-Service (FFS) providers. The Claims Clues provides information about changes to the program, system changes and updates, billing requirements and FFS policies.



Additional information can be found in the Encounter Keys newsletter.

2024

March 2024

  • March is National Nutrition Awareness Month
  • Extension of the Provider Moratorium to June 8, 2024
  • Billing Companies and Clearing House Cannot Submit a Request for ERA (835) Setup
  • Referring, Ordering, Attending (ROPA) Providers Required to Register with AHCCCS
  • Review Of Documentation Signature Requirements
  • Special Billing Information and Updates
  • Common Behavioral Health Claim Denial Edits
  • Claim Denial Code AD282 Missing Provider Signature
  • Claim Denial Code AD283 Invalid Member ID Information AMPM940(III) (A) (1) (B)
  • Behavioral Health Documentation Requirements
  • Reminders: TIBCO Transaction Insight Web Upload Attachment
  • Checking Your Claim Status
  • Submitting a Replacement Claim
  • Corrections to Previously Processed Claims
  • FRAUD, WASTE AND ABUSE

February 2024 - Special Editions

February 2024

  • February is Heart Health Awareness Month
  • ID.Me Registration Now Required for all AHCCCS Online Users
  • Important: AHCCCS Registration is Required for all Behavioral Health Professionals Providing Clinical Oversight
  • New Provider Quick Training Guide
  • FFS Provider Tools and Resources: Prior Authorization Correction Form
  • Provider Online Resources and Training Guides
  • Common Prior Authorization Submission Errors
  • FFS Prior Authorization Requirements for Add-On Surgery Codes
  • AHCCCS Claim Processing Edits and Descriptions
  • Submitting A Clean Claim
  • Reminder: New 2024 American Dental Association Claim Form
  • Reminder: Participating Provider Reporting Requirements Edit Denial Codes H482.1 and H482.7
  • Extension of the Provider Moratorium to June 8, 2024.
  • AHCCCS Daily Trip Report Reminders

February 2024 - Special Editions

January 2024

  • AHCCCS Adds ID.me Security to Provider Portal
  • Important Billing Code Change: Place of Service Code 56 for BHRF Provider Type (B8) Only
  • Behavioral Health Claim Denial Codes
  • Extension of the Provider Moratorium to June 8, 2024
  • End Stage Renal Disease (ESRD) NEMT Prior Authorization Submissions
  • AHCCCS Provider Enrollment Portal (APEP) - Adding a Provider Service Location
  • MCO Claim Denials – Health Plan Enrollment
  • Coming January 2024! New 2024 American Dental Association Claim Form
  • Prior Authorization Lookup Tool
  • What Happens When the Prior Authorization Does Not Match The Service?
  • Modification Request: How to Add a Missing Provider Service Location In APEP
  • How to Correct the Duplicate Prior Authorization Case Creation Error
  • Identifying Claim Problems
  • Behavioral Health Services Billing and Coding H2016 and H0038 Same Day Billing Denial Edit L237.4

2023

December 2023

  • Checking Claim Status using the AHCCCS Online Provider Portal
  • Behavioral Health Claims - Missing Documentation Denial Reason Codes
  • H2016 and H0038 Same Day Billing Denial Edit L237.4
  • Inpatient Psychiatric Facility (PT 71) Prior Authorization Submission Tips
  • Important Billing Code Change: Place of Service Code 56 for BHRF PT (B8)
  • Documentation Requirements for Behavioral Health Outpatient Claims
  • New Denial Code AD281 Medical Documents Do Not Conform to AMPM Policy 940
  • New 2024 American Dental Association Claim Form
  • Community Health Workers and Community Health Representatives (CHW/CHR)
  • Hysterectomy Consent and Acknowledgement Form
  • Elective Sterilization Consent Form Requirement
  • How to Check the Status of a Behavioral Health Claim and Documentation
  • How to Create a Paper Work Numbers (PWK)
  • Prior Authorization Lookup Tool
  • Common Prior Authorization Submission Errors
  • Prior Authorization Submission Tips - PT 02 Hospital – Outpatient Day Surgery
  • Prior Authorization Tip: Outpatient Surgery – Physician Prior Authorization Request
  • What Happens When The Prior Authorization Does Not Match The Service
  • Selecting the Correct Claim Number To Submit a Replacement Claim
  • Duplicate Prior Authorization Case Error Message
  • How to Add a Provider Service Location in (APEP) Modification Tutorial
  • 275 Transaction Insight Portal Batch Option Is Available - How to Sign Up!
  • Transaction Insight Portal Reminders for Provider Types 77, 05 and IC

December 2023-Chiropractor Service Codes Update

November 2023

  • AHCCCS Online Provider Portal Password Reset Requests
  • Receive DFSM Email News Updates and Provider Training Notifications
  • Important: Effective June, 9, 2023 Provider Moratorium
  • Important Master Account Holder Changes
  • AHCCCS Restricts Providers’ Ability to Bill on Behalf of Others
  • Tribal Self-Insurance and Required Documentation
  • 835 Electronic Remittance Advice Requests
  • 275 Transaction Insight Portal Batch Option
  • DFSM Prior Authorization Quick Training Guides
  • Behavioral Health Claims-Missing Documentation Denial Reason Codes
  • Provider Type 02 Hospital-Prior Authorization Submission Requirements
  • Memo Release Date October 24, 2023: Fee for Service Prior Authorization Review Times
  • Common Prior Authorization Submission Errors
  • Reminder: Participating Provider Reporting Requirements Edit Denial Codes H482.1 and H482.7
  • Prior Authorization Tips
  • How to Add the Missing Event Information to an Existing PA
  • How to Add the Missing Activity Information to an Existing PA

October 2023

  • Linking Between AHCCCS Online Provider Portal and the Transaction Insight Portal
  • Transaction Insight Portal Reminders for Provider Types 77, 05 and IC
  • TIBCO and Attaching Documentation for BH Claims
  • 275 Transaction Insight Portal Batch Option
  • What Happens When the Prior Authorization Does Not Match the Service?
  • Checking Claim Status using the AHCCCS Online Provider Portal
  • Behavioral Health Claims-Missing Documentation Denial Reason Codes
  • Inpatient Psychiatric Facility (Provider Type 71) Prior Authorization Submission Tips
  • Rate Changes Effective 10/01/2023
  • How to Add the Missing Event Information to an Existing PA
  • How to Add the Missing Activity Information To An Existing PA
  • Prior Authorization Tips
  • Transaction Insight Portal (TIBCO) FAQs
  • Claim Date Span Billing Requirement

September 2023

  • Receive DFSM Email News Updates and Provider Training Notifications
  • Reminder: Rate Changes Effective 10/01/2023
  • Reminders: Participating Provider Reporting Provider Types 77, IC and 05
  • Documentation Review for Behavioral Health Outpatient Claims
  • Reminders: Important Effective June, 9, 2023 Provider Moratorium
  • Reminder: Participating Provider Reporting Requirements Edit Denial Codes H482.1 and H482.7
  • Reminders: 275 Transaction Insight Portal (TIBCO)
  • Transaction Insight Portal (TIBCO) FAQS
  • How to Check Receipt of Documentation Using the AHCCCS Online Provider Portal
  • How to Add the Missing Event Information To An Existing PA
  • How to Add the Missing Activity Information To An Existing PA
  • Uploading Documentation To A Prior Authorization Request
  • Prior Authorization Tips

August 2023

  • Important: Effective June, 9, 2023 Provider Moratorium
  • Important: Behavioral Health Billing Codes Documentation Requirements
  • DFSM New Training Tutorials!
  • Required Documentation For Outpatient Behavioral Health Claims
  • Documentation Review for Behavioral Health Outpatient Claims
  • Important: AHCCCS Changes Enrollment Procedures for the American Indian Health Program (AIHP)
  • Participating Provider Reporting Requirements Edit Denial Codes H482.1 and H482.7
  • Provider Type 02 Hospital - Prior Authorization Submission Reminders
  • AHCCCS Online Provider Portal Password Reset Requests
  • AHCCCS Online Provider Portal Registering Under the Group Billing Provider (01) NPI
  • How to Register Your Group Billing Account On the AHCCCS Online Portal
  • How to Verify if the Service Provider is linked to the Group Billing Provider
  • Important Master Account Holder Changes

July 2023

  • Required Documentation For Outpatient Behavioral Health Claims
  • AHCCCS Audio Only Telehealth Changes Modifier FQ
  • Transaction Insight Portal (TIBCO) File Size and Types
  • Reminder: Non-Emergency Medical Transport Diagnosis Codes
  • New and Revalidating Behavioral Health Providers Subject to High-Risk Screening
  • Behavioral Health Services Billing and Coding H2016 and H0038 Same Day Billing Denial Edit L237.4
  • Provider Type 02 Hospital - Prior Authorization Submission Reminders
  • AHCCCS Restricts Providers’ Ability to Bill on Behalf of Others
  • Psychiatric Hospital Provider Type 71 Prior Authorization Diagnosis Code Mismatch
  • Reminder: Non-Emergency Medical Transportation (NEMT) Policy Change for Local Community Based Support Programs
  • Prior Authorization Tips For Provider Type 71 Psychiatric Hospital
  • Claim Date Span Billing Requirement
  • Electronic Visit Verification (EVV) Edit Tips Edit Denial Code: L227.1 Claim Line Failed For Unmatched Units, Field is Missing

July 2023 - Outpatient Behavioral Health Billing Update

  • Required Documentation For Outpatient Behavioral Health Claims

June 2023

  • Multi-Systemic Therapy (MST)
  • CR Modifier and DR Condition Code Covid-19 Emergency Related
  • Medical Coding Resources - Code Coverage Changes
  • Community Health Workers and Community Health Representatives (CHW/CHR)
  • Transaction Insight Portal for Outpatient Behavioral Health Providers How to Attach Documentation for Specific BH Service Codes
  • Prior Authorization Tips For Provider Type 71 Psychiatric Hospital
  • Diabetes Self-Management Training (DSMT)
  • Dental Tooth Code Number Assignment
  • Prior Authorization Guidelines
  • Principal Diagnosis versus Admitting Diagnosis Codes UB-04
  • All Patient Refined Diagnosis Related Groups (APR-DRG) Classification System DRG Ungroupable Denials
  • Filing a Reconsideration for APR-DRG Payments
  • Reminder: Billing Vaccines for Children (VFC)
  • Reminder: Missing AHCCCS 835 and Paper Remittance Advice
  • Claim Date Span Billing Requirement

May 2023

  • Alternate Care Site (ASC) Flexibility Ending for Indian Health Service (IHS) and Tribally Owned/Operated (638) Facilities
  • Reminder: Claim Date Span Billing Requirement
  • Attendant Care Provider Type 40 Non-Emergency Medical Transportation Services
  • Selecting the Correct Event Type for Medical and Behavioral Health Admissions
  • Common Prior Authorization Submission Errors
  • Prior Authorization Tips
  • When is a Faxed Prior Authorization Request Acceptable
  • Verifying if a Service Requires a Prior Authorization
  • Prior Authorization Submission Tips
  • PA Tip: Outpatient Surgery – Physician Prior Authorization Request
  • PA Tip: BHRF (Provider Type B8) Prior Authorization Request
  • BHRF Criteria for Continued Stay
  • Inpatient Psychiatric Facility (Provider Type 71) Prior Authorization Submission Tips
  • Uploading Documentation To A Prior Authorization Request
  • How to Add the Missing Event Information To An Existing PA
  • How to Add the Missing Activity Information To An Existing PA
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit

May 2023 - Transaction Insight Portal for Outpatient Behavioral Health Providers

  • How to Attach Documentation for Specific BH Service Codes

May 2023 - Clarification of Billing Requirements for Behavioral Health Outpatient Claims

  • H0004 (Behavioral Health Counseling and Therapy)
  • H0038 (Self-Help/Peer Services)
  • H2011 (Crisis Intervention Service)
  • H2014 (Skills Training and Development)
  • H2015 (Comprehensive Community Support Services)
  • H2017 (Psychosocial Rehabilitation Services)
  • H0025 (Behavioral Health Prevention Education Service)
  • H2027 (Psychoeducational Service)
  • S5150 (Unskilled Respite Care, Not Hospice)
  • T1016 (Case Management)
  • T1019 (Personal Care Services)
  • H0034 (Medication Training and Support)

May 2023 - Special Edition

  • Service Ticket Request For Electronic Remittance Advice (ERA) 835 Setup
  • If you are missing your ERA/835 Remits

April 2023

  • Alternate Care Site (ASC) Flexibility Ending for Indian Health Service (IHS) and Tribally Owned/Operated (638) Facilities
  • Denial Edit - L013.5 Claim Service Requires Prior Authorization, PA Not Found
  • Claim Edit Review Tips
  • Common Prior Authorization Submission Errors
  • Effective 10/14/2022 Covered Dental Services at an IHS/638 Facility Are Unlimited
  • Additional Reimbursements of the Pharmacy All Inclusive Rate (AIR) for the Administration of COVID-19 and Influenza Immunizations are Ending
  • BHRF Criteria for Continued Stay
  • Selecting the Correct Event Type for Medical and Behavioral Health Admissions
  • Reminders Transaction Insight Portal
  • Prior Authorization Tips
  • Verifying if a Service Requires a Prior Authorization
  • Reminder: Referring/Ordering Provider Requirement
  • AHCCCS FFS New Vendor Notification Medicaid Travel Services Provider
  • Easy Access to Provider Training Presentations via Constant Contact
  • Denial Edit AD962 Referring/Ordering Provider NPI Is Not Listed
  • Tribal Self-Insurance and Required Documentation
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit

March 2023

  • Claim Date Span Billing Requirement
  • Claim Denials Information
  • AHCCCS FFS New Vendor Notification Medicaid Travel Services Provider
  • APEP Reminder –Service Addresses Can Be Updated Directly in APEP
  • Prior Authorization Reminders
  • Reminder: Common PA Submission Errors
  • AHCCCS FFS New Vendor Notification Medicaid Travel Services Provider
  • Attendant Care Provider Type 40 Non-Emergency Medical Transportation Services
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit

February 2023

  • AHCCCS FFS New Vendor Notification Medicaid Travel Services Provider
  • Attendant Care Provider Type 40 Non-Emergency Medical Transportation Services
  • Who Can Become an American Indian Medical Home (AIMH)
  • Prior Authorization Reminders
  • Effective 10/14/2022 Covered Dental Services at an IHS/638 Facility Are Unlimited
  • REMINDER: NEMT Pick Up and Drop Off Address
  • EVV Update on Hard Claims Edits
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit

January 2023

  • Effective 10/14/2022 Covered Dental Services at an IHS/638 Facility Are Unlimited
  • Reminder: Provider Participation Reporting Requirements
  • Diabetes Self-Management Training
  • Claim Denials Information
  • EVV Update on Hard Claims Edits
  • Payment Error Rate Measurement (PERM) Audit
  • How To Determine if a Prior Authorization Is Required
  • Reminder: Common PA Submission Errors
  • What is Payment Error Rate Measurement (PERM) Audit
  • APEP Reminder –Service Addresses Can Be Updated Directly in APEP
  • Prior Authorization Reminders
  • REMINDER: NEMT Pick Up and Drop Off Address
  • Reminder: Common PA Submission Errors
  • Provider Self-Service Tips AHCCCS Online Provider Portal
  • Pended Prior Authorization Request Information

2022

December 2022

  • Effective 10/14/2022 Covered Dental Services at an IHS/638 Facility Are Unlimited
  • Diabetes Self-Management Training
  • Public Health Emergency
  • Provider Participation Modifier Deadline Extended Until January 1, 2023
  • Missing Remittance Requests
  • Reminder: Electronic Visit Verification
  • Reminder: Common PA Submission Errors
  • Reminder: Paper Claim Submission Errors
  • Reminder: Billing Per Diem Codes
  • 835/Electronic Remittance Advice (ERA)
  • AHCCCS To Start 10-Month Process to Disenroll Non-Compliant Providers

November 2022

  • Effective 10/14/2022 Covered Dental Services at an IHS/638 Facility Are Unlimited
  • Payment Error Rate Measurement (PERM) Audit
  • Important Updates
  • What is Payment Error Rate Measurement (PERM) Audit
  • Missing Remittance Requests
  • Serious Mental Illness (SMI) Changes Effective 10/1/2022
  • Reminders: Behavioral Health Residential Facility (BHRF) Admission
  • Important Update: Provider Participation Reporting Requirements Deadline Has Been Extended Until January 1, 2023

October 2022

  • Serious Mental Illness (SMI) Changes Effective 10/1/2022
  • Behavioral Health Residential Facility Policy 320-V Update
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit
  • Important Update: Provider Participation Reporting Requirements Deadline Has Been Extended Until January 1, 2023
  • APEP Reminder - Service Addresses Can Be Updated Directly in APEP
  • Quick Reference Guide - What Services Require A FFS Prior Authorization
  • Missing Remittance Requests
  • Provider Self-Service Tips AHCCCS Online Provider Portal

September 2022

  • Serious Mental Illness (SMI) Changes Effective 10/1/2022
  • 835/Electronic Remittance Advice (ERA)
  • Reminders: Behavioral Health Residential Facility (BHRF) Admission
  • Payment Error Rate Measurement (PERM) Audit
  • What is Payment Error Rate Measurement (PERM) Audit
  • Participating Provider Reporting Requirements Effective 10/1/2022
  • Provider Denial Resolution Guide
  • APEP FAQs
  • Reminders: Fee-for-Service Prior Authorizations
  • Reminder: Transaction Insight Portal- Important Information for Users

July/August 2022

  • Serious Mental Illness (SMI) Changes Effective 10/1/2022
  • Payment Error Measurement (PERM) Audit
  • Participating Provider Reporting Requirements Effective 10/1/2022
  • Provider Denial Resolution Guide
  • Tips: Behavioral Health Prior Authorization
  • Tips: BHRF Prior Authorization Reminders
  • DD-THP Tribal Health Program Prior Authorization Forms
  • Update: AHCCCS Prior Authorization and Concurrent Review Standards during the COVID-19 Emergency for Fee-for-Service Providers
  • AHCCCS Provider Enrollment Portal (APEP)
  • Review of Documentation Signature Requirements
  • Reminder: Non-Emergency Medical Transportation (NEMT) Policy Change for Local Community Based Support
  • Reminder: Transaction Insight Portal-Important Information for Users Reporting the Date of Service
  • Reminders: Important Billing Information for Paper Claims Submissions

March 2022

  • DD Tribal Health Plan (THP)
  • Office of the Inspector General (OIG) Provider Participation Agreement
  • Participating Provider Reporting Requirements
  • Payment Error Rate Measurement (PERM) Audit
  • Transaction Insight Portal-Important Information for Users Reporting the Date of Service and Provider Address Fields
  • Transaction Insight Portal-PWK Using the AHCCCS 12 Digit Claim Reference Number (CRN)
  • Important Billing Information for Providers-Common Billing Errors on Paper Claim Submissions
  • Transportation Requests

January/February 2022

  • Payment Error Rate Measurement(PERM) Audit
  • CMS Extension of “Four Walls” Grace Period for IHS and Tribal 638 Facilities
  • First Quarter Provider Training Schedule Posted
  • General Requirements for the Submission of Paper Claim Forms
  • Transportation Requests
  • Transportation Passes/Bus Passes
  • AHCCCS Prior Authorization and Concurrent Review Standards during the COVID-19 Emergency for Fee-for-Service Programs
  • Tribal ALTCS Digital Tool
  • COVID-19
  • Transaction Insight Portal – Important Information for Users Who Select Non-Person Entity
  • Electronic Visit Verification (EVV)
  • AIHP Transportation Request Process

2021

October 2021

  • CMS Extension of “Four Walls” Grace Period for IHS and Tribal Providers
  • AIHP Transportation Request Process
  • Transportation Requests
  • Transportation Passes/Bus Passes
  • Electronic Visit Verification (EVV)
  • Emergency Triage, Treat and Transport (ET3)
  • COVID-19 Information
  • Tribal ALTCS Digital Toolbox
  • Transaction Insight Portal – Important Information for Users Who Select Non-Person Entity
  • Prior Authorization Updates and Reminders

September 2021

  • Emergency Triage, Treat and Transport (ET3)
  • Medical Review Documentation Requirements
  • Documentation Requirements and the Transaction Insight Portal
  • Transaction Insight Portal - Important Information for Users Who Select Non-Person Entity
  • COVID-19 Prior Authorization and Concurrent Review Standards During the Publich Health Emergency for Fee-for-Service Programs
  • APEP FAQs
  • Prior Authorization Updates and Reminders
  • APEP Updates - Service Addresses May Now Be Updated Directly in APEP
  • ROPA: Referring, Ordering, Prescribing, Attending (ROPA) Providers Required to Register with AHCCCS
  • Tribal ALTCS Digital Toolbox

August 2021

  • APEP Updates – Service Addresses May Now Be Updated Directly in APEP
  • APEP FAQs
  • IHS & 638 Tribal Facility / Pharmacy Authorization Form for Submission to OptumRx
  • Transaction Insight Portal - Important Information for Users Who Select Non-Person Entity
  • ROPA
  • Fee for Service Authorization Reminders
  • Quality Management (QM) Housekeeping Tips
  • NEMT Daily Trip Report Instructions

July 2021

  • Transaction Insight Portal – Important Information for Users Who Select Non-Person Entity
  • Court Ordered Treatment FAQ Update
  • DFSM Provider Training Team’s Third Quarter Schedule Posted
  • APEP
  • APEP and Adding Service Locations
  • BHRF Notifications
  • Medicare EOB
  • ROPA
  • Quality Management Housekeeping Tips
  • AHCCCS Prior Authorization (PA) and Concurrent Review (CR) Standards during COVID-19 for Fee-for-Service Health Programs
  • Behavioral Health Residential Facility (BHRF) Notification
  • Behavioral Health Residential Facility (BHRF) – Per Diem Rate Information

May/June 2021

  • ROPA
  • Recoupment (Applies to All Providers)
  • Fee For Service Prior Authorization
  • Non-Emergency Medical Transportation (NEMT) Daily Trip Report Instructions
  • NEMT Resources
  • NEMT – Transportation of Family Members is Not Permitted
  • General Reminders for All Providers
  • Attendant Care Non-Emergency Medical Transportation & Special Considerations
  • Use of the AHCCCS Online Provider Portal – Why NOT Sharing Your User ID and Login Information is VERY Important
  • Upcoming APEP Training Sessions
  • What is the AHCCCS Provider Enrollment Portal (APEP)?
  • APEP and Adding Service Locations
  • Payment Error Measurement (PERM) Audit Information for Providers
  • Telehealth Resources
  • Telehealth Services and IHS/638 Providers
  • Second Quarter Training Schedule Posted
  • COVID-19 Information on the AHCCCS Website & Billing for Services
  • COVID-19 Billing for Services

March/April 2021

  • Upcoming APEP training sessions
  • Medicare EOB
  • Quality Management (QM) Housekeeping Tips
  • Preferred Provider Lists
  • Vaccination Memos
  • 2021 All Inclusive Rate
  • Payment Error Measurement Audit Information for Providers
  • Telehealth
  • Electronic Visit Verification (EVV)
  • Second Quarter Training Schedule Posted
  • COVID-19 Billing for Services
  • COVID-19 Information
  • COVID_19 FAQs
  • The U.S. Department of Health and Human Services (HHS) Releases COVID-19 Care and Vaccine Access Fact Sheets
  • AHCCCS Prior Authorization (PA) and Concurrent Review (CR) Standards during COVID-19 Emergency for Fee-for-Service Health Programs
  • AHCCCS Provider Enrollment Portal (APEP)

January/February 2021

  • 2021 All Inclusive Rate Update
  • First Quarter Provider Training Schedule Posted
  • Vaccination Memos for Providers
  • COVID-19 Information

2020

November/December 2020

  • ROPA Update – Extension of Timelines
  • Sandata EVV System Users – Preparation for the Welcome Kit Release
  • Non-Emergency Medical Transportation Updates and Reminders
  • Documentation Requirements on the Transaction Insight Portal (TI)
  • Claim Tips Corner – Claim Submission Errors on CMS 1500 Claim Forms
  • Online Prior Authorization Reminders
  • IHS 638 Nursing Facility and Skilled Nursing Facilities AIR Updates
  • COVID-19 Information
  • COVID-19 Modifier Use
  • Provider Location within the United States
  • Long Acting Reversible Contraceptives (LARC)
  • Behavioral Health Matrix Reminder
  • Vaccination Billing Information for IHS & Tribal Providers

October 2020

  • EMS Providers and Flu Shots
    • AHCCCS Reimbursement Options for EMS Agencies Administering Flu Vaccine
  • Flu Vaccine Administration for Members 3-18 Years of Age
  • Electronic Visit Verification Information
  • Provider Location within the United States
  • COVID-19 Information
  • COVID-19 Modifier Use
  • Referring, Ordering, Prescribing and Attending (ROPA) Providers
  • IHS 638 Nursing Facility and Skilled Nursing Facilities AIR Updates
  • Long Acting Reversible Contraceptives (LARC)
  • Claim Tips Corner – Claim Submission Errors on CMS 1500 Claim Forms
  • Documentation Requirements and the Transaction Insight (TI) Portal
  • Behavioral Health Matrix Reminder
  • AHCCCS Prior Authorization (PA) and Concurrent Review (CR) Standards during COVID-19 Emergency Fee-for-Service Health Programs
  • Behavioral Health Transportation Responses (Questions and Answers)

September 2020

  • Flu Vaccine Administration for Members 3-18 Years of Age
  • Documentation Requirements and the Transaction Insight Portal (TI)
  • Referring, Ordering, Prescribing and Attending (ROPA) Provider Notification “Don’t Be the Weak Link in the Chain!”
  • Electronic Visit Verification (EVV) Reminders and Training Information
    • Please note EVV announcements are only applicable to providers subject to EVV requirements. For additional information on EVV please visit the AHCCCS EVV web page.
  • COVID-19 Information
  • COVID-19 FAQs
  • COVID-19 “CR” Modifier Use
  • IHS 638 Nursing Facility and Skilled Nursing Facilities AIR Updates
  • Claim Dispute Process – Office of Administrative Legal Services (OALS)
  • AHCCCS Announces Provider Enrollment Portal (APEP) Launch
  • Telehealth Reminders
  • Behavioral Health Facilities Providing Personal Care Services
  • Behavioral Health Residential Facility (BHRF) – Prior Authorization Documentation Requests
  • Behavioral Health Residential Facility (BHRF) Trainings
  • AHCCCS Prior Authorization (PA) and Concurrent Review (CR) Standards during COVID-19 Emergency for Fee-for-Service Health Programs
  • Provider Training Schedule Fourth Quarter 2020

July/August 2020

  • COVID-19 - FAQs and CR Modifier Use
  • Long Acting Reversible Contraceptives (LARC)
  • Telehealth Materials on the AHCCCS Website
  • The "Four Walls" Provision and IHS & 638 Providers
  • Billing for Telehealth and Telephonic Services as an IHS/638 Provider
  • AHCCCS Provider Enrollment Portal (APEP) Information - Launch Date of August 31, 2020
  • AHCCCS Prior Authorization (PA) and Concurrent Review Standards during COVID-19 Emergency for Fee-for-Service (FFS) Health Programs
  • Behavioral Health Services Matrix
  • Claim Dispute Process - Office of Administrative Legal Services (OALS)
  • Referring, Ordering, Prescribing, and Attending (ROPA) Providers Flier - Register by January 1, 2021

June 2020

  • COVID-19 & FAQs
  • Telehealth
  • Contact Information
  • The "Four Walls" Provision and IHS & 638 Providers
  • Billing for Telehealth and Telephonic Services as an IHS/638 Provider
  • AHCCCS Announces Provider Enrollment Portal (APEP) Launch Date Change - August 31st, 2020
  • Electronic Visit Verification (EVV) Update
  • Claims - How to Register as a Provider and Receive Payment for Services Rendered
  • Prior Authorization and Concurrent Updates
  • Tribal Relations Corner
    • Upcoming AHCCCS Special Tribal Consultation Meetings
    • Providers Can Be Reimbursed for COVID-19 Testing and Treatment for Uninsured Arizonans Through Federal HRSA Web Portal
    • AHCCCS Policies Open for Tribal Consultation as of 5/21/2020
  • Upcoming Training Schedule - June 2020

April/May 2020

  • COVID-19
  • COVID-19 FAQs
  • Telehealth
  • Contacts
  • EVV
  • APEP Updates
  • American Indian Medical Home (AIMH)
  • Claims Disputes Process - OALS
  • Federal Emergency Services Recipients
  • Medicare Savings Programs - FFS
  • 2020 All Inclusive Rate (AIR) Updates

March 2020

  • Long Active Reversible Contraceptives (LARC)
  • Arizona Court Care Website – Involuntary Treatment or “Civil Treatment” Process
  • Behavioral Health Residential Facility (BHRF) Notification for Codes H0031 an H2019
  • General Requirements for the Submission of Paper Claim Forms
  • Tribal ALTCS Web Page
  • Billing Reminders for the CMS 1500 and UB-04 Claim Forms
  • AHCCCS Provider Enrollment Portal (APEP) to Launch June 1st, 2020
  • New Standards and Reporting Requirements for Opioid Treatment Programs
  • Electronic Visit Verification (EVV)
  • Provider Training Web Page
  • Federal Emergency Service Recipients
  • Upcoming Provider Trainings

January/February 2020

  • Tribal ALTCS Web Page
  • AHCCCS Provider Enrollment Portal (APEP) Updates- Launching on June 1st, 2020
  • Electronic Visit Verification (EVV) Updates
  • Covered Behavioral Health Services Guide (CBHSG) Transition Reminder
  • Telehealth Services Reminder
  • New Standards and Reporting Requirements for Opioid Treatment Programs
  • Provider Training Web Page
  • Upcoming Provider Training Sessions

2019

November/December 2019

  • Tribal ALTCS Web Page - NEW!
  • AHCCCS Provider Enrollment Portal (APEP) to Launch June 1st, 2020 - Launch Date Changed!
  • Telehealth Services - Important Update
  • APR-DRG Payment Policy Update
  • Covered Behavioral Health Services Guide - Important Update
  • Behavioral Health Facilities Provider Personal Care Services
  • Behavioral Health Residential Facility - Prior Authorization Documentation Requests
  • Transaction Insight Portal (TI)
  • Claims Status Inquiries using the AHCCCS Online Provider Portal and via the Claims Customer Service Phone Line
  • Claim Submission - Medicare/Third Party Liability
  • AHCCCS Complete Care (ACC) Health Plan Contact Information
  • A0998 Article - Billing Manual Update

October 2019

  • AHCCCS Provider Enrollment Portal (APEP) to Launch in 2020
  • Vaccine Administration and Point of Sale System Billing to Optum
  • Electronic Prescribing of Controlled Substances (EPCS) - Memo Regarding State of Arizona House Bill 2075, Dated October 23rd, 2019
  • Arizona Controlled Substances Prescription Monitoring Program
  • House Bill 2075 Reminders with Additional Resource Information
  • AHCCCS Fee for Service Drug List & T(RBHA) Drug List Effective 10/01/2019
  • APR-DRG Payment Policy Update
  • Covered Behavioral Health Services Guide – Important Update
  • Telehealth Services – Important Update
  • Behavioral Health Facilities Providing Personal Care Services
  • Non-Emergency Medical Transportation Daily Trip Report Reminders
  • Naturopathic Physicians

September 2019

  • ***Additional Trainings Added for 3rd Quarter
  • Assistant Surgeon Modifier (AS) and Modifier AS Notification
  • Multi-Specialty Interdisciplinary Clinic Update (MSIC)
  • Provider Enrollment Updates
  • Master PDF Documents of the Fee-for-Service and IHS/Tribal Provider Billing Manuals to Replace ZIP Files
  • Telehealth Policy Updates
  • BHRFs Providing Personal Care Services

August 2019

  • APR-DRG Policy
  • Provider Enrollment Updates (Automated Online Provider Enrollment System to Launch in 2020)
  • Master PDF Documents of the Fee-for-Service and IHS/Tribal Provider Billing Manuals to Replace ZIP Files
  • Retroactive Coverage (also called Prior Quarter Coverage)
  • Adult Immunization Coverage
  • Behavioral Health Residential Facilities Notification
  • Direct Care Worker Agency Monitoring
  • Four Walls Requirement
  • Training Schedule for the 3rd Quarter

July 2019

  • AHCCCS Adult Immunization Coverage at County Health Departments
  • Retroactive Coverage (also called Prior Quarter Coverage)
  • Retroactive Coverage
  • Direct Care Worker Agency Monitoring
  • Behavioral Health Residential Facility (BHRF) Per Diem Rate Information
  • Covered Behavioral Health Services Guide - Important Notice
  • Training Schedule for 3rd Quarter

June 2019

  • Provider Welcome Letter
  • Provider Office Check List
  • Retroactive Coverage
  • Behavioral Health Residential Facility (BHRF) Notification
  • Behavioral Health Residential Facility (BHRF) Per Diem Rate Information
  • Transition of Covered Behavioral Health Services Guide
  • 3D Mammograms
  • Upcoming Trainings

May 2019

  • Covered Behavioral Health Services Guide - Important Update
  • Automated Online Provider Enrollment System to Launch in 2019
  • Training Opportunities (Technical Assistance Webinar; BHRF PA Submission Training; General Direct Care Agency Worker; One-on-Ones; Claims and Disputes)
  • Electronic Visit Verification Differential Adjusted Payment Notice (DUE 05/20/2019)
  • Request for Electronic Remittance Advice (ERA) or 835 Transaction Setup (FAQs)
  • Accessing Behavioral Health Services in Schools
  • BHRF Notification
  • 3D Mammograms

April 2019

  • BHRF Notification/Update
  • Covered Behavioral Health Services Guide - Important Update
  • OALS Claims Dispute Process
  • Notice of Non-Discrimination
  • Provider Registration (Enrollment) Updates
  • Accessing Behavioral Health Services in Schools
  • Coordination of Care
  • What is the AIMH?

March 2019

  • Care Coordination: FFS Programs
  • Notice of Non-Discrimination
  • Addressing the Increase of Syphilis in Arizona
  • BHRF Notification
    • *Updated April 2019
  • Covered Behavioral Health Services Guide – Important Update
  • Pharmacy Updates

February 2019

  • CBHSG Updates
  • BHRF Notification
  • QMB Only, QMB Dual, and Non-QMB Dual Member Copays
  • What Does a Tribal ALTCS Membership Card Look Like?

January 2019

  • Pharmacy Services for AIHP Members
  • Remittance Advice FAQs
  • Billing the Global OB When Delivery Occurs at a Different Facility
  • General Reminders
  • Paper Claim Reminders
  • Member Eligibility – How to Check if a Member is Designated SMI
  • Are Contracts Needed for FFS Members? (No)
  • Covered Behavioral Health Services Guide Transition – Important Updates
  • The American Indian Health Program (AIHP) – An integration topic.
  • Behavioral Health - An integration topic.
  • Billing Considerations – An integration topic.

Integration Special Edition

This edition of Claims Clues is dedicated to providing providers with information about Integration, which begins on 10/01/2018. It contains enrollment and billing information.

  • The Future of Integrated Healthcare
  • 10/1/18 Enrollment Changes for Members
  • The American Indian Health Program
  • Behavioral Health
    • This article includes a screenshot detailing what a member's eligibility screen will look like, after 10/01/2018, if they are receiving behavioral health services through AIHP.
  • Billing Considerations for:
    • AIHP/AIHP-enrolled members,
    • AIHP/TRBHA-enrolled members, and
    • AHCCCS Complete Care (ACC) enrolled members.
  • CRS Updates
  • Provider Training Information
    • ACC Training will be held by our Provider Training division and dates and sign-up information is included.
  • Answers to the following questions:
    • Are contracts needed to provide services to FFS members?
    • How can I submit a claim for a FFS member?
    • How can I submit a PA request for a FFS member?

2018

December 2018

  • Covered Behavioral Health Service Guide Transition - Important Update
  • Behavioral Health Residential Facility (BHRF) Notice
  • What is the difference between AIHP and IHS?
  • Reminder for NEMT Providers (Registration Process of Employees)
  • Direct Care Worker Agency Monitoring
    • Training dates for January:
      • Wednesday, January 16th
      • Wednesday, January 23rd
  • NEMT Reminders and Unloaded Mileage
  • Privacy Rules and Continuity of Care
  • Claims - How to Register as a Provider and Receive Payment for Services Rendered
    • Provider Registration
    • Enrolling in AHCCCS Online
    • Electronic Remittance Advice (ERA/835) Setup
    • Claim Submission
    • Documentation Submission & Enrolling for the Transaction Insight Portal
    • Payments
  • Field 43 and Reporting the Medicaid Drug Rebate Data (NDC Number)
  • CMS 1500 Claim Form Updates
    • Updates/Clarifications on Fields 24I, 24J, 33a, and 33b
  • Reminder that Fee-For-Service providers do not need to contract with AHCCCS AIHP, Tribal ALTCS, or a TRBHA to continue providing Medicaid Title XIX/XXI services to FFS members. A provider simply must be an AHCCCS registered provider. Contracts are not needed.

November 2018

  • Emergency Dental Services
  • Request for Electronic Remittance Advice (ERA) or 835 Transaction Setup (FAQs)
  • Integration Billing Information
  • NEMT AHCCCS Daily Trip Report Reminders
  • Pharmacy Services for AIHP Members
  • Direct Care Worker Agencies
  • Reminder Regarding the FFS & IHS/Tribal Provider Billing Manual Usage
  • Fee-for-Service Authorization Reminders
  • Crisis Services
  • Crisis Hotline Phone Numbers
  • Global OB Billing for IHS/638 Facilities

October 2018

  • October Provider Training
  • Crisis Services
  • AHCCCS Online Claim Disputes
  • Billing Reminders for the CMS 1500 and UB-04 Claim Forms
  • Paper Claim Reminders
  • Acronyms
  • Where to Go if You Have ACC Questions

Integration Special Edition

This edition of Claims Clues is dedicated to providing providers with information about Integration, which begins on 10/01/2018. It contains enrollment and billing information.

  • The Future of Integrated Healthcare
  • 10/1/18 Enrollment Changes for Members
  • The American Indian Health Program
  • Behavioral Health
    • This article includes a screenshot detailing what a member's eligibility screen will look like, after 10/01/2018, if they are receiving behavioral health services through AIHP.
  • Billing Considerations for:
    • AIHP/AIHP-enrolled members,
    • AIHP/TRBHA-enrolled members, and
    • AHCCCS Complete Care (ACC) enrolled members.
  • CRS Updates
  • Provider Training Information
    • ACC Training will be held by our Provider Training division and dates and sign-up information is included.
  • Answers to the following questions:
    • Are contracts needed to provide services to FFS members?
    • How can I submit a claim for a FFS member?
    • How can I submit a PA request for a FFS member?

September 2018

  • Open House Announcement
  • Direct Care Workers
  • Billing Manual Purpose Reminder
  • Fee for Service Authorization Reminders
  • 1500 Paper Claim Forms (Box 21) ICD-10 Diagnosis Reminder
  • Integration
  • Ground Ambulance

August 2018

  • Provider Education Dates
  • Non-Emergency Medical Transportation Updates
  • New: Open House
  • What is Integration and Who is Affected?
  • Integration Billing Information
  • Policies Rescinded

July 2018

  • Linking between AHCCCS Online and the Transaction Insight Portal
  • Medical Documentation Reminders
  • What is Integration and Who is Affected?
  • PERM Audit - Where do you stand?

June 2018

  • Behavioral Health Prior Authorization Requests
  • Online Prior Authorization (PA) Submission Requirements for FFS Providers Effective 07/01/2018
  • Federal Emergency Service Plan (FESP) Member Prior Authorization Requirements
  • Medical Authorization Reminders
  • The Updated AHCCCS Daily Trip Report is Now Available
  • 638 FQHCs

May 2018

  • Participants in the Targeted Investments Program
  • Behavioral Health Prior Authorization Requests
  • Online Prior Authorization (PA) Submission Requirements for FFS Providers Effective 7/1/18
  • Federal Emergency Service Plan (FESP) Member Prior Authorization Requirements
  • FAQ Round Up (Case Management & FQHCs; Group Therapy & FQHCS; and American Indian Medical Homes that are also an FQHC or a 638 FQHC)

April 2018

  • 638 FQHCs
  • General Requirements for the Submission of Paper Claim Forms
  • All Inclusive Rate (AIR) Provider Billing Manual Updates
  • Coding Updates for Modifiers JG and TB

March 2018

  • AMPM 320-N - Prior Authorization Requests for Direct
  • Acting Antiviral Medication Treatment for AHCCCS Members
  • Age 18 Years and Older
  • Occupational Therapy
  • Demographic Transition Communication
  • Transportation Reminders
  • Medical Authorization Reminders

February 2018

  • Fee-For-Service Authorization Reminders
  • Transportation
  • Medical Authorization
  • Home Health Services
  • Family Planning
  • Orthotics and Prosthetics
  • Use of Social Determinants of Health Codes for Member Outcomes

January 2018

  • Billing 59 Modifier
  • Inpatient Outlier Review Process
  • PERM Audit: Where Do You Stand?
  • Online Prior Authorization Submission–New Document Attachment Feature

2017

December 2017

  • Home Infusion
  • Non-Physician Billing of Vaccinations & Emergency Injections
  • Combatting the Opioid Use Disorder Crisis with Medication Assisted Treatment (MAT)
  • Online Prior Authorization Submission–New Document Attachment Feature

November 2017

  • Podiatric Services
  • DFSM Billing Tips
  • Home Health Services
  • Notification to Applicants of the Targeted Investments Program

October 2017

  • Dental Benefits
  • Billing - 59 Modifier
  • Home Health Services

September 2017

  • Home Health Services - Face to Face Requirements
  • DFSM Billing Tips

August 2017

July 2017

June 2017

  • Federal Emergency Services Program (FESP)
  • Paper Claims Submission Font Issue

May 2017

  • BH PA Process Training notice
  • DFSM Training Schedule

April 2017

  • Article on TRBHAs and List of TRBHAs
  • DFSM Training Schedule
  • AHCCCS Contacts and links

February 2017

  • Overpayments
  • Fee-For-Service (FFS) Prior Authorization Information and Reminders
  • DFSM Training Schedule
  • UPDATE: AHCCCS - Constant Contacts replaces ListServ
  • Claim Reminders
  • UB Medical Review - Suggested Documentation
  • AHCCCS Contacts, Links and Resources

January 2017

  • Reminder: AHCCCS will be closed February 20, 2017 (Monday) to observe President’s Day
  • Fee-For-Service (FFS) Prior Authorization Reminder
  • Behavioral Health NEMT Updates and Reminders
  • DFSM Training Schedule
  • AHCCCS Contacts and links

2016

December 2016

  • Reminder: AHCCCS will be closed January 2, 2017 (Monday) to observe New Year’s Day.
  • Non-Emergency Medical Transportation (NEMT)
  • DFSM Training schedule
  • AHCCCS Contacts and links

November 2016

  • Week of December 12, 2016 Fee-For-Service Payments and Remits Will Be Delayed One Day
  • Reminder: AHCCCS will be closed December 26, 2016 (Monday) to observe Christmas Day.
  • Non-Emergency Medical Transportation (NEMT)
  • DFSM Training schedule
  • AHCCCS Contacts and links

October 2016

  • Genetic Testing Prior Authorization – Correction
  • Reinstatement: Coverage of Podiatry Services Performed by a Licensed Podiatrist
  • Reinstatement : ALTCS Dental
  • Third Party Liability (TPL)
  • Non-Emergency Medical Transportation (NEMT)
  • AHCCCS Contacts and Links

September 2016

  • Reminder: AHCCCS will be closed Monday, October 10, 2016
  • Long Acting Reversible Contraceptive (LARC)
  • Reinstatement: Coverage of Podiatry Services Performed by a Licensed Podiatrist
  • ALTCS Dental Benefit
  • Referrals for NEMT Trips Beyond "nearest facility"
  • Dental Review Process for Deep Sedation/General Anesthesia
  • Prior Authorization Request Timeframes
  • Provider Registration Required for Licensed Board Certified Behavior Analysts (BCBA)

August 2016

  • New Provider Type: Free-Standing Emergency Departments (FrEDs)
  • Proposed Reinstatement: ALTCS Dental Benefit
  • Reinstated: Coverage of Podiatry Services Performed by a Licensed Podiatrist
  • KidsCare is Reinstated Effective September 1, 2016
  • Reminder: Tribal Regional Behavioral Health Authority Provider Notification
  • Paper Claim Submission Issues

July 2016

  • KidsCare is Re-Instated Effective September 1, 2016
  • Prior Authorization Request Timeframes
  • Provider Registration Required for Licensed Board Certified Behavior Analysts (BCBA)

June 2016

  • UM/CM Unit Name Change to CMSU Effective 7/1/2016
  • Provider Registration Required for Licensed Board Certified Behavior Analysts (BCBA)
  • Provider Records Retention Requirements
  • Provider "Going Out of Business" Process

May 2016

  • Genetic Testing Requires Prior Authorization
  • Tribal Regional Behavioral Health Authority Provider Notification
  • Dental Review Process Change for Deep Sedation/General Anesthesia
  • Claims Customer Service Tips

April 2016

  • Tribal Regional Behavioral Health Authority Provider Notification
  • Dental Review Process Change For Deep Sedation/General Anesthesia
  • APR-DRG On Interim Claims
  • Submitting Medical Records For An EDI Claim
  • When Your Claim Is Denied For Medical Documentation
  • NEMT Providers - Provider Registration Records Update
  • AHCCCS Provider Participation Terminated For Inactivity
  • DFSM Claims Customer Service Reminders
  • Are You Signed Up for Important Provider Notices?

March 2016

  • Hospital Presumptive Eligibility HPE
  • DFSM Claims Customer Service Tips
  • Are You Signed Up for Important Provider Notices?

February 2016

  • Provider Records Retention Requirements
  • Provider "Going Out of Business" Process
  • Claims Customer Service Tips - Using AHCCCS Online
  • Inpatient Outlier Review Process

January 2016

  • Attention Providers: Claim Submission System Downtime
  • AHCCCS Webpage Has a New Look!!
  • When Other Coverage is Primary
  • NEMT Providers: Provider Registration Records Update
  • Referrals for NEMT Trips Beyond "nearest facility" for AIHP
  • Behavioral Health Fee Schedule
  • Reminder: FREE Online Services for AHCCCS Providers

2015

November 2015

  • NEMT Coverage & Limitations
  • Prior Authorization Submission
  • Continuous Glucose Monitoring (CGM)
  • Home Infusion of Inotropic Medications
  • Provider Training Email Address
  • Mandated Hospice Rate Changes Effective 01/01/2016
  • Fee-For-Service Claims Payment Questions?

October 2015 Special Edition

  • Greater Arizona Integrated Care Update

September 2015

  • Reminder: Transition from ICD-9 to ICD-10 on 10/01/2015
  • ICD-10 Diagnosis Code on ADA Form - Correction
  • ICD-10 Implementation and Prior Authorization Changes
  • Reminder: Claims Received 9/28/15 and 9/29/15
  • Delayed: Changes to AHCCCS Covered Behavioral Health Services
  • Dental Service Requirements for IHS and Tribal 638 Providers

August 2015

  • Reminder: Transition from ICD-9 to ICD-10 on 10/01/2015
  • Adult Orthotic Benefit Change Effective 8/1/2015
  • Significant Changes to AHCCCS Covered Behavioral Health Services
  • Visiting the AHCCCS Administration Office?
  • Claims Submitted 9/28/15 and 9/29/15

July 2015

  • Coding/POS Updates
  • NEMT Trip Report Issues
  • Reminder: Revised Trip Report & Instructions
  • Billing FQHC/RHC Claims with a Primary Payer - Correction
  • Reminder: FREE Online Services for AHCCCS Providers
  • Are You Signed Up for Important Provider Notices?

June 2015

  • Reminder: Fee for Service (FFS) Provider Payment Changes
  • Digital X-rays
  • Billing FQHC/RHC Claims with a Primary Payor
  • Still Submitting Paper Claims to AHCCCS FFS?

May 2015

  • Fee For Service Provider Payment Changes
  • Still Submitting Paper Claims to AHCCCS FFS?
  • Provider Registration Changes for Provider Type 40 - Update

April 2015

  • Medically Unlikely Edits (MUEs)
  • Revised NEMT Trip Report and Instructions
  • Reminder: Paper Claim Submissions
  • Provider Registration Changes for Provider Type 40

March 2015

  • Coding Changes/Updates
  • FQHC / RHC

February 2015

  • Reminder: Claim Status - Pending
  • Reminder: Transition from ICD-9 to ICD-10 effective 10/1/2015
  • Coding Changes/Updates

January 2015

  • Correction - Coding Changes Effective 01/01/2015
  • Correction - Provider Training Email Address
  • Claims Status - Pending
  • Recipient Signature on NEMT Trip Report
  • Reminder - FQHC/RHC Payment Process Change Delayed

2014

December 2014

  • FQHC/RHC Changes Delayed
  • Coding Changes Effective 01/01/2015
  • NEMT Provider Reminder
  • New Provider Training Email Address
  • IHS/638 Claim Audit Memo

October 2014

  • Re-enrollments for NEMT & Group Billing Providers
  • FQHC AND RHC PAYMENT PROCESS CHANGE
  • PERM Audit Reminder

System Notice September 2014

  • No Claims Load Into System 9/24 - 9/30/14

August 2014

  • Billing Reminder
  • Did You Know...?
  • When AHCCCS Requests Medical Documentation
  • 2 Policy Changes for NEMT Providers
  • REMINDER: Transition from ICD-9 to ICD-10 code sets delayed until 10/1/2015

July 2014

  • Billing Reminder
  • Did You Know...?
  • Timely Filing Denials
  • Claims Process Definitions
  • New Policy Changes for NEMT Providers
  • Reminder - ICD-10 Transition Delay

June 2014

  • NEMT Policy - Tribal Business Licenses Required
  • 2014 1st Quarter NEMT Quality Audits
  • Reminder - Transition to ICD-10 Delayed
  • Reminder - New ADA 2012 Version
  • PERM 2014 Cycle "Save the Date" Webinars

May Claims Clues Supplemental

  • AZ DOC Special Edition Notice

May 2014

  • Billing Reminder
  • UB04 Date Discrepancies
  • NOTICE: Transition from ICD-9 to ICD-10 delayed until 10/1/2015
  • New ADA form 2012 Version
  • PERM 2014 Cycle CMS Provider Education
  • Monthly NEMT Quality Audits

April 2014

  • Billing Reminders
  • Note from Provider Registration
  • PERM Cycle 3 Provider Education Webinar/Conference Calls

March 2014

  • Correction of February 2014 NEMT Article
  • Billing Reminders
  • NEMT Policy Changes Effective 4/1/2014
  • PERM Cycle 3 Arizona
  • PERM 2014 "Save The Date"

February 2014

  • OVER USE & MISUSE of 99285
  • Submitting Claim Documentation
  • NEMT (Provider Type 28) Policy Changes
  • PERM 2014 CYCLE
  • October 2013 NEMT Claim Audit

2013

December 2013

  • PERM 2014 CYCLE
  • NEMT TRIP REPORT REVISED
  • AHCCCS PROVIDER PARTICIPATION TO BE TERMINATED FOR INACTIVITY
  • MEDICARE LIABILITY

November 2013

  • NEMT TRIP REPORT REVISED
  • SEPTEMBER 2013 NEMT CLAIM AUDIT RESULTS
  • REMINDERS FROM THE Care Management Systems Unit’S PRIOR AUTHORIZATION UNIT
  • MEDICARE LIABILITY

October 2013

  • PAYMENT ERROR RATE MEASUREMENT (PERM)
  • PRIOR QUARTER COVERAGE ELIGIBILITY
  • REMINDERS FROM THE Care Management Systems Unit’S PRIOR AUTHORIZATION UNIT

October 2013 - Special Edition

  • Prior Quarter Coverage Eligibility

August 2013

  • AHCCCS Fee for Service Non-Emergency Medical Transportation (NEMT) Changes
  • CMS Approved Supplemental Waiver Payments for Option 1 & Option 2 Ends 12/31/13
  • PERM Audit - Where do you stand?
  • Reporting Vaccine Administration Codes with E/M Codes

July 2013

  • Important Arizona Department of Corrections (ADOC) Information
  • General Reminders From the UM/CM's Prior Authorization Unit
  • 2013 FFS Provider Training Schedule
  • Payment Error Rate Measurement (PERM) 2014
  • Reporting Vaccine Administration Codes with E/M Codes

June 2013

  • Important Arizona Department of Corrections (ADOC) Information
  • Changes coming for Non-Emergency Transport Claims
  • Reminders From the UM/CM's Prior Authorization Unit
  • Enhanced Rates for Primary Care Services

May 2013

  • Changes coming for Non-Emergency Transport Claims
  • Reminders From the UM/CM's Prior Authorization Unit
  • Enhanced Rates for Primary Care Services

April 2013

  • Enhanced Rates for Primary Care Services
  • General Care Management Systems Unit Reminders
  • AHCCCS' Tribal Health Care Coordinator
  • Update on Govenor Brewer's Medicaid Restoration Plan

March 2013

  • Information from The Office of The Inspector General
  • Correction to January 2013 Article
  • A Bit of Claims Trivia
  • Reminders From the UM/CM's Prior Authorization Unit

February 2013 - Supplemental

  • Primary Care Provider Enhanced Fee Attestation for AHCCCS Registered Providers

February 2013

  • Information from The Office of The Inspector General
  • Claims Tips and Reminders
  • PERM 2012 Errors
  • Vaccine Administration Reporting Changes - Including the VFC Program
  • New Requirements for Submission of Claims for Vaccine Administration - FAQ's
  • General Reminders from the Care Management Systems Unit's PA Unit

January 2013

  • Enhanced Payments to Primary Care Providers
  • Agency with Choice
  • Reminders from UM/CM Prior Authorization