AHCCCS Technical Interface Guidelines (TIG)

 

Health Plan Interface - Recipient Action Transaction Codes (RF403)


CODE DESCRIPTION TYPE INDICATOR
$P MANUAL PAYMENT A Y
$R MANUAL RECOUPMENT D Y
AA ALGORITHM ASSIGNED A N
AC ADDRESS CHANGE C N
AE APPLIED FOR NEW ELIGIBLITY D Y
AI ADMIN-IN A N
AO ADMIN-OUT D Y
BI ENROLLMENT BLOCK IN A N
BO ENROLLMENT BLOCK OUT D Y
CH ELIG CHANGE CAUSES DISENRL D Y
CI COUNTY MOVE-IN A N
CO COUNTY MOVE-OUT D Y
DB DATE OF BIRTH CHANGE C N
DE DECEASED D Y
EC ENROLLMENT CHOICE A N
EI OPEN ENROLLMENT-IN A N
EO OPEN ENROLLMENT-OUT D Y
FI FAMILY CONTINUITY-IN A N
FO FAMILY CONTINUITY-OUT D Y
HC ACUTE HEALTH PLAN CHANGE C N
HK HOSPITALIZED, KICK TO BE PAID    
HO MOVE OUT OF HEALTH PLAN AREA D Y
IE INELIGIBLE D Y
MA MASS ADJUSTMENT RECOUPMENT D Y
MC MENTAL HEALTH CHANGE C N
MI MEDICAL CARE CONTINUITY-IN A N
MO MEDICAL CARE CONTINUITY-OUT D Y
MR MASS ADJUSTMENT PAYMENT A Y
NB NEWBORN A N
NC NAME CHANGE C N
NE NORMAL ENROLLMENT A N
NP NORMAL ENROLLMENT-PRIOR PLAN A N
OS OUT OF STATE MOVE D Y
PA END OF CONTRACT-IN: AUTO ASSIGN A N
PD END OF CONTRACT-IN: DIRECT MOVE A N
PG PREGNANT WOMEN C N
PO END OF CONTRACT-OUT: DIRECT MOVE D Y
PP END OF CONTRACT-IN: PERCENTAGE A N
PR END OF CONTRACT-IN: RULE MATRIX A N
PT END OF CONTRACT-OUT: %, AUTO, RULE D Y
RA RETROACTIVE ENROLLMENT A N
RC RATE CODE CHANGE C N
RE RE-ENROLLMENT A N
RO RECOUPMENT MHS D Y
SB SUPPLEMENTAL BIRTH PAYMENT C N
SC SHARE OF COST CHANGE C N
SX SEX CHANGE C N
TM MENTAL HEALTH TERMINATION C N
VW VOLUNTARY WITHDRAWAL D Y