AHCCCS Claims Clues

Claims Clues is a newsletter produced periodically by the AHCCCS Claims Department for Fee-For-Service (FFS) providers. It provides information about the following:

  • Changes to the program
  • System changes and updates
  • Billing policies and requirements

Additional information can be found in the Encounter Keys newsletter.

Note: Information provided in PDF files.

2011 Editions

December 2011 [33KB]

  • Identification of Ordering Provider to be Required
  • Member Photos to be Added as Verification Tool
  • 99281 and 99282 No Longer a Covered Service for FES
  • AHCCCS Provider Training Schedule for 2012
  • PERM Medical Documentation Notification Letters
  • All Genetic Testing Requires Prior Authorization
  • 5010 Change Made to the Web
  • Reminder About Medicare EOMB's

November 2011 [47KB]

  • Member Photos to be Added as Verification Tool
  • Important FES Changes
  • Fee or Service Editing
  • Identification of Ordering Provider to be Required
  • PERM Update
  • Fee For Service Billing Reminder
  • AHCCCS Secure FTP Notification
  • 835/MREP Changes

October 2011 [37KB]

  • Important Fee Changes
  • Identification of Ordering Provider to be Required
  • Save Time - Use the PA Web Portal
  • Documentation Submission for PERM
  • Claim Tips & Reminders
  • Allowable Payments for Emergency Room Care vs Urgent Care
  • AHCCCS Announces the Departure of Dr. Jennifer Amen

October 2011 - Supplemental [16KB]

  • Important News About Fee For Service Payments

September 2011 [111KB]

  • Important Fee Changes
  • Prior Authorization Changes for AHCCCS Fee For Service
  • Benefit Limits & PA Policy
  • AHCCCS Respite Benefit Change Effective October 1, 2011
  • AHCCCS Benefit Changes Effective October 1, 2011: Annual Limits For Inpatient Days And Respite Services
  • In-Patient Limit: Member & Contractor Responsibility Acute & Altcs Members 21 Years Of Age And Older (Medicaid Only, QMB Dual and Non-QMB Dual Status)
  • Claim Tips & Reminders
  • “DOC TALK” - A Message from the AHCCCS Medical Director Jennifer Heaton Amen MD
  • PERM Medical Review Just Around The Corner

August 2011 [49KB]

  • Phoenix Fee For Service Provider Meeting
  • 837 Claims Companion Guide
  • PERM Webinars Coming Soon
  • Prior Authorization Changes for AHCCCS Fee For Service
  • AHCCCS Respite Benefit Change Effective October 1, 2011
  • AHCCCS Benefit Changes Effective October 1, 2011: Annual Limits For Inpatient Days And Respite Services
  • In-Patient Limit: Member & Contractor Responsibility Acute & Altcs Members 21 Years Of Age And Older (Medicaid Only, QMB Dual and Non-QMB Dual Status)

July 2011 [62KB]

  • Phoenix Fee For Service Provider Meeting
  • 835 ERA  Retrieval Website
  • Provider Notice  - Progesterone Therapy
  • Hospice Coverage for Acute Care Recipients
  • New Prior Authorization Requirements
  • Benefits of using 275 Electronic Attachments
  • Claims Tips and Reminders
  • Updated Guidelines for Billing of Arizona Department of Corrections Claims to AHCCCS
  • 2011 Perm Cycle Due to Begin

June 2011 [49KB]

  • Phoenix Fee For Service Provider Meeting
  • Record Keeping Requirements for Non-Emergency Transportation Providers
  • System Updates
  • New Information Posted to AHCCCS Website
  • Important Prior Authorization Information
  • AHCCCS FFS Claims Re-Review Process

May 2011 [30KB]

  • Mandatory Unpaid Furlough Days to End
  • New Information Posted to AHCCCS Website
  • Training for Non-Emergency Transportation Providers Scheduled
  • PERM Claims Submission Has Begun
  • A Reminder About Synagis

April 2011- Supplemental [17KB]

  • COST SHARING
    Currently any Fee for Service (FFS) enrolled member is exempt from cost sharing. In addition, effective May 1, 2011 American Indians enrolled in a managed care organization will no longer have cost sharing.

April 2011 [67KB]

  • Mandatory Unpaid Furlough Days to End
  • AHCCCS Restores Coverage of Previously Covered Transplants for Adults
  • AHCCCS Provider Participation to be Terminated For Inactivity
  • Direct Care Workers
  • Rate Reduction Exemption For IHS/638 Providers
  • FAQ's For the American Indian Health Program and ALTCS FFS
  • Visiting the AHCCCS Administration Offices?
  • PERM 2011 Update

March 2011 [45KB]

  • AHCCCS Administration Offices to Close for Furlough Days
  • AHCCCS Provider Participation to be Terminated for Inactivity
  • 2011 PERM Update
  • Transportation Prior Authorization Information
  • Provider Rate Reduction Information
  • Claim Tips and Reminders

February 2011 [43KB]

  • AHCCCS Administration Offices to Close for Furlough Days
  • PERM Update
  • Prior Authorization Changes In AHCCCS Fee For Service
  • Associated Claims Recoupment Project
  • Claims Tips & Reminder
  • Unspecified Dental Procedure Codes To Require PA
  • Medical Documentation