AHCCCS Fee-For-Service (FFS) Technical Assistance Documents

The FFS technical documents provided below are intended to to help registered AHCCCS providers use the AHCCCS Online website.

• 835 Electronic Remit Technical Assistance Document
• Uploading 275 Claim Attachments Technical Assistance Document
• Prior Authorization Web Portal User Manual
• On-line Claim Submission Manual (Currently under revision)
• Ambulatory Surgical Center (ASC) Technical Assistance Document

Note: Information provided in PDF files.

835 Electronic Remit Technical Assistance Document

This document provides technical guidance for retrieving, viewing, and printing 835 Electronic Remits using Secure File Transfer Services (SFTS) in conjunction with Medicare Read Easy Print (MREP) software.

835 Electronic Remit Technical Assistance Document [3.05MB]

Uploading 275 Claim Attachments Technical Assistance Document

This document is intended as a reference for those responsible for uploading attachment files to support FFS claims to AHCCCS Division of Fee-For-Service Management (DFSM).

Uploading 275 Claim Attachments Technical Assistance Document [860KB]

Prior Authorization Web Portal User Manual

This manual provides technical guidance for submitting a prior authorization through the FFS Prior Authorization Web Portal.

Prior Authorization Web Portal User Manual [800KB]

FFS On-line Claim Submission Manual

The FFS On-line Claim Submission Manual provides technical guidance for submitting claims on-line.

Download Entire Manual

• FFS On-line Claim Submission Manual [Zip 5.2MB]

Download Individual Chapters

• Table of Contents [20KB]
• Section 1: How to Sign On [893KB]
• Section 2: Create an ID and Password [330KB]
• Section 3: Check Eligibility and Enrollment Status [334KB]
• Section 4: Claim Submission [190KB]
  • Section 4a: Professional (1500) [208KB]
  • Section 4b: Institutional (Inpatient UB) [182KB]
  • Section 4c: Institutional (Outpatient/Clinic UB) [948KB]
  • Section 4d: ADA (Dental) [920KB]
• Section 5: View Status (Online Claim) [532KB]
• Section 6: Claim Status [731KB]
• Section 7: Adjustments (CMS 1500) [350KB]
  • Section 7a: Adjustments (UB) [275KB]
  • Section 7b: Adjustments (ADA) [225KB]

Ambulatory Surgical Center (ASC) Technical Assistance Document

This manual provides technical guidance for billing ASC Claims through the internet, paper, or the 837 ASC.

ASC Technical Assistance Document [997KB]