AHCCCS Financial Reporting Guidelines

The Arizona Health Care Cost Containment System (AHCCCS) provides Reporting Guides for Acute Care and Long Term Care Contractors.

Acute Health Care Contractors

The purpose of the Reporting Guide for Acute Health Care Contractors is to set forth the monthly, quarterly, and annual reporting requirements for acute care contracting health plans (Contractors). The primary objective of the Guide is to establish consistency and uniformity in reporting.

Financial Reporting Guide for Acute Health Care Contractors [PDF, 273KB]

• Appendices A-F [Excel, 405KB]
  • Appendix A: Certification Statement
  • Appendix B: Financial Statement Reporting Instructions & Audit Report
  • Appendix C: Financial Statements
  • Appendix D: Financial Statement Footnote Disclosures
  • Appendix E: Supplemental Reports
  • Appendix F: Audit Reconciliation Report
• Appendix G [Word, 44KB]
  • Financial Disclosure Statement
  • Related Party Transactions
• Template FQHC Member Months E-9 [Excel, 28KB]
• Mapping Matrix [Word, 55KB]
• Medicare SNP Template [Excel, 62KB]

Arizona Long Term Care System (ALTCS) Health Care Contractors

The purpose of the Financial Reporting Guide for the Arizona Long Term Care System (ALTCS) is to set forth the monthly, quarterly, annual, and ad hoc financial related reporting requirements for ALTCS Program Contractors.

Financial Reporting Guide for ALTCS Program Contractors [PDF, 872KB]

• Appendix: Financial Reporting Instructions [Excel, 684KB]
• Appendix: FQHC/RHC Member Months [Excel, 402KB]