AHCCCS Claims Clues

Claims Clues is a newsletter produced periodically by the AHCCCS Claims Department for Fee-For-Service (FFS) providers. It provides information about the following:

Changes to the program
System changes and updates
Billing policies and requirements

Additional information can be found in the Encounter Keys newsletter.

Select A Year
- 2023
- 2022
- 2021
- 2020
- 2019
- 2018
- 2017
- 2016
- 2015
- 2014
- 2013

2023

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

Targeted Investments Program
DFSM Billing Tips
Online PA - New Document Attachment Feature
AMPM Policy 310H

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