AHCCCS Plans, Providers, Contractors & Vendors

Here, you can find information about how to register as a provider, verify member eligibility and enrollment status, submit claims, and obtain manuals, guides, and forms.

AHCCCS Transition to Inpatient DRG Payments

AHCCCS has contracted with Navigant Consulting http://www.navigant.com/ to provide assistance in analyzing the impact of, and potentially acquiring and implementing, a DRG-based inpatient hospital payment system. More information can be found on the AHCCCS Transition to DRG-based Payment web page.

AzAHP Credentialing Alliance

The Arizona Association of Health Plans (AzAHP), representing the organizations that contract with AHCCCS to provide for the health care needs of Arizona’s Medicaid members, is pleased to announce the creation of a new Credentialing Alliance aimed at making the credentialing and recredentialing process easier for our providers by eliminating duplication of efforts and reducing administrative burdens. Before the launch of the Alliance, practitioners who contract with the various AHCCCS health plans needed to have their credentials established and refreshed with each individual health plan in a costly and duplicative process. Today, through the entrepreneurial efforts of AzAHP, it’s now a one stop credentialing shop for those in our networks. Additional information regarding the new AzHHP Credentialing Alliance may be found in the provider notification below.
Provider Notification

AHCCCS Managed Care Organization Update Meeting

Given the unprecedented interest in the upcoming Acute Care RFP, the AHCCCS Administration wants to ensure that MCO meetings and opportunities to interact with AHCCCS leadership are transparent and equitable. Consequently, AHCCCS is commencing an AHCCCS Managed Care Organization (MCO) Update Meeting for current AHCCCS Contractors and other interested managed care organizations.

Meetings will be held at AHCCCS (701 E Jefferson, Gold Room, Phoenix, Arizona) from 9:30 a.m. - 12:00 p.m. on the following dates:

• May 16, 2012
  
  • Meeting Agenda
  • Meeting Presentations/Materials
• July 18, 2012
  This meeting is being canceled while we work through options for state policymakers to consider in light of the Supreme Court's ruling. The Governor's office will lead stakeholder discussions to obtain input regarding the path forward for the State's Medicaid program.
• September 19, 2012
  • Meeting Agenda
  • Meeting Presentations/Materials
    
• February 20, 2013
  • Meeting Agenda
  • Meeting Presentations/Materials
• May 1, 2013
  • Meeting Agenda
  • Meeting Presentations/Materials
    

You may RSVP for the meeting by emailing Alma Torres at Alma.Torres@azahcccs.gov. Please limit participation to 2 representatives from your managed care organization.

AHCCCS Transition to ICD10

AHCCCS will be working on a transition to the ICD10 code set effective for outpatient/professional dates of service and Inpatient dates of discharge 10/1/2014 and after. More information can be found on the AHCCCS ICD10 Consortium web page. http://www.azahcccs.gov/commercial/EDIresources/ICD10.aspx

Quick Links

• Acute/CRS RFP
• Health Care Acquired Conditions and Other Provider Preventable Conditions
• Fee-For-Service Rates
• Member Enrollment Verifications
• Newborn Notifications
• Provider Registration
• Minimum Subcontract Provisions
• Fee-For-Service Claim Submissions
• Contracts and Solicitations
• Contractor Operations Resources
• Direct Care Worker Program
• Data Access Forms
• Mainframe/LAN Downtime Schedule
• Month End File Availability
• Electronic Data Interchange (EDI) Resources
• AHCCCS Contractor Listing [PDF, 100KB]
• Laboratory Results Required for Quality Improvement
• Pharmacy Updates
• Nursing Facility Information [PDF, 23KB]

• Fraud Awareness for Providers
• Reporting Quality of Care Concerns Presentation