You are invited to participate in a survey regarding your experience using the AHCCCS
website. This survey will take approximately two minutes. Your responses will help
us ensure that you have a high quality experience.
The Prior Authorization Correction Form is to be utilized to request changes to an existing Prior Authorization. Any additional medical documentation for this request should be submitted with this request. The form must be completed in its entirety.
Prior Authorization Correction Form
You may phone or fax the AHCCCS Prior Authorization Unit to request authorization.
To obtain a prior authorization by telephone, providers must call Monday
through Friday between 9am to 11:30am, and 12:30pm to 4pm.
The AHCCCS Prior Authorization Unit's fax number is 602-256-6591.
Allow at least three working days for your request to be processed.
Adobe Acrobat Reader is required to view PDF files. This is a free program available
from the Adobe web site. Follow the download directions on the Adobe
web site to get your copy of Adobe Acrobat Reader.