Claims Customer Service 

Claims

The Division of Member and Provider Services (DMPS) manages the Claims Customer Service calls for AHCCCS Fee For Service (FFS) recipients.

To better serve our provider community, AHCCCS FFS offers providers the ability to status their claims on the AHCCCS Website. By utilizing this service providers will receive immediate status on claims that have been submitted for their FFS clients.

DFSM has developed the Provider Denial Resolution Guide for FFS providers. This tool provides claim denial assistance with understanding the denial edits and descriptions, and steps to take to help resolve the edit. New denial edits will be added periodically to the guide. The information presented on the website is to provide general guidance only. Providers maintain the responsibility to ensure all claims are billed appropriately.

The Division of Member and Provider Services unit is designed to assist providers with complex claim inquiries. Providers should use the on-line claim status as the first step in checking the status of claims/payments. For claims assistance providers can submit a ticket to servicedesk@azahcccs.gov. In the request, specifically indicate the request is about a claim for division of fee for service management and include a specific CRN or ICN number. If the question is about a claim with an AHCCCS Managed Care Organization (MCO), then you must contact the MCO directly. To reach Provider Service, call (602) 417-7670.

Education and Training Questions

The DFSM Provider Education and Training Unit can assist providers with the following:

  • How to submit and status claims or prior authorization requests through the AHCCCS Online Provider Portal (FFS programs, including AIHP, TRBHAs and Tribal ALTCS)
  • Submission of documentation using the Transaction Insight Portal (e.g., The AHCCCS Daily Trip report, requested medical records, etc.)

The DFSM Provider Education and Training Unit does not instruct providers on how to code or bill for a particular service. The DFSM Provider Training Team can be outreached at providertrainingffs@azahcccs.gov.

Rates: Questions on AHCCCS FFS rates should be directed to the rates team at FFSRates@azahcccs.gov

Coding: Questions on AHCCCS coding should be directed to the coding team at CodingPolicyQuestions@azahcccs.gov

If you have questions about warrants, paper EOBs, or provider payments please email the Division of Business & Finance (DBF) at ahcccswarrantinquiries@azahcccs.gov or call (602)417-5500

To check the status of your EFT please email the Division of Business & Finance (DBF) at ahcccsfinanceeft@azahcccs.gov

For questions on the 835 Transaction Remittance also known as Electronic EOB please contact ISD at servicedesk@azahcccs.gov

Providers should use the online website as the first step in checking the status of the claim. Our Provider Services representatives are skilled to provide help to many basic claims questions. To reach Provider Services call (602) 417-7670.

Provider Services Operation Hours:
Monday-Friday from 7:30 A.M. - 5:00 P.M.

Can't find what you're looking for? Please visit the AHCCCS Document Archive.
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