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AHCCCS On-line Claim Submission Manual
IMPORTANT: The links below lead to individual files in PDF format. Or you can click here to download the entire manual at once in a self-extracting ZIP compressed archive (6523.91 KB). Some of the hyperlinks in these PDF files lead to other PDF files in the manual. You must save all of the manual's files to the same location for these internal links to work.
TABLE OF CONTENTS (15.8KB)
| Section 1: | How to Sign On (281KB) | |
| Section 2: | Create an ID and Password [312KB] | |
| Section 3: | Check Eligibility and Enrollment Status [96.2KB] | |
| Section 4: | Claim Submission [120KB] |
| Section 4.a. | Professional (1500) [626KB] | |
| Section 4.b. | Institutional (Inpatient UB) [923KB] | |
| Section 4.c. | Institutional (Outpatient/Clinic UB) [922KB] | |
| Section 4.d. | ADA (Dental) [8996KB] |
| Section 5: | View Status (Online Claim) [520KB] | |
| Section 6: | Claim Status [714KB] | |
| Section 7: | Adjustments (CMS 1500) [612KB) |
| Section 7.a. | Adjustments (UB) [402KB] | |
| Section 7.b. | Adjustments (ADA) [510KB] |
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| Web Site Privacy Policy | Contact AHCCCS | Site Map |
| AHCCCS, 801 E. Jefferson, Phoenix, AZ 85034, (602) 417-4000 |
| Send your Member and Provider questions and comments to the Public Information Office. |
| Copyright 2003 Arizona Health Care Cost Containment System (AHCCCS), All Rights Reserved |
| This page was last modified on Friday, May 16, 2008 at 1:35:16 PM |
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