AHCCCS Technical Interface Guidelines (TIG)

Health Plan Interface - Review File

• Introduction
• Schedules
• Media
• Testing
• Reference Documents

Introduction

Review files Identify acute members who are up for review at either DES or KidsCare in the next month. The Review Files process provides an opportunity for health plans to remind patients to comply with the eligibility agency's requirements for review in order to prevent a stoppage in coverage. Processing of this file is on a voluntary basis, but it is recommended.

Schedules

• Review File runs on the third day of each month and is normally completed by midnight. File is named ccyymm.REV and is available in the plan’s folder under AZ/hpmnemonic/PROD/OUT

Media

Review File notifications are produced in data file format. Health Plans, or their services bureaus, must connect to the Arizona Health Care Cost Containment System (AHCCCS) FTP server and download the data file for batch processing.

Testing

It is highly recommended that Review File transmissions be tested in coordination with the AHCCCSA ISD operations staff prior to production implementation of a new Health Plan or change in service bureau, or as a result of changes. Typical testing of file transmission takes approximately one week.

Reference Documents

• Review File Layout