American Indian Health Provider Resources
- American Indian Health Program (AIHP)
- American Indian Health Facilities (ITUs)
- Arizona Long Term Care (ALTCS) Tribal Case Management
- AHCCCS IHS/Tribal Provider Billing Manual
- AIHP/FFS Prior Authorization Form
- American Indian Health Program Technical Assistance
- IHS/638 NDC FAQs Updated July 2016
- IHS/638 NDC Training Presentation June 2016
- 4 Articles: NDC Billing Requirements 7/1/2016
- IHS/638 Billing on UB-04: Eff 01/01/2016 Attending Provider
FAQs for the American Indian Health Program and ALTCS FFS
What is the American Indian Health Program (AIHP)?
The AHCCCS Acute Fee For Service Program for American Indians, administered by the State through the Division of Fee For Service Management at AHCCCS.
Who can treat AIHP members?
Any AHCCCS Registered Provider that has not opted out of fee for service. The AHCCCS FFS Program does not contract with individual providers.
How do you submit a claim for an American Indian?
|If member is enrolled in AIHP and you are an AHCCCS FFS Provider (any AHCCCS Registered Provider that has not opted out of fee for service).||Claims are submitted to AHCCCS/Division of Fee For Service Management (DFSM).|
|If member is enrolled with managed care or a program contractor and services are NOT provided at an IHS/Tribal 638 facility.||Claims are submitted directly to the plan / program contractor.|
|If member is enrolled with managed care or a program contractor and services ARE provided at an IHS/Tribal 638 facility.||Claims are submitted to AHCCCS/DFSM.|
|If member is receiving Behavioral Health services at an IHS/Tribal 638 facility.||Claims are submitted to AHCCCS/DFSM.|
|If member’s Behavioral Health Services are NOT provided at an IHS/Tribal638 facility.||Claims are submitted to the member’s RBHA or TRBHA.|
|If member receives Transportation and Case Management services for Behavioral Health, regardless of where the services were received.||Claims are submitted to the member’s RBHA or TRBHA.|
The *primary method of submission is the AHCCCS Online web portal.Fax (secondary)
- PA – 602-256-6591
- UR – 602-254-2304
- LTC – 602-254-2426
- BH – 602-253-6695 *For BH, fax is primary method
- Transport – 602-254-2431
- 1-602-417-4400 (Phoenix area direct line to the PA area)
- 1-800-433-0425 (In state direct line into the PA area)
- 1-800-523-0231 (Out of state line to AHCCCS switchboard; dial extension 6024174400 or ask for PA area)
- AHCCCS-Division of Fee-for-Service Management
Care Management System Unit (CMSU), Mail Drop 8900
701 East Jefferson Street
Phoenix, AZ 85034
All authorization requests must include clinical documentation supporting the medical necessity for the services requested. Use of PA Forms is mandatory.
Please use these links to Chapter 820 in the AMPM; Chapter 6 in the IHS/638 Provider Billing Manual; and Chapter 8 in the FFS Provider Manual.
AIHP, FES (Federal Emergency Services), Tribal ALTCS (including Gila River Indian Community, Hopi Tribe, Navajo Nation, Pascua Yaqui Tribe, San Carlos Apache Tribe, Tohono O’Odham Nation, White Mountain Apache Tribe, and Native American Community Health), and QMB Only. A QMB Only is a Non-AHCCCS Member who retains original Medicare coverage and has no AHCCCS health plan enrollment. The member opts out of “QMB Dual” coverage, and AHCCCS pays for coinsurance and deductible for Medicare.
For more information on ALTCS Tribal, please visit the ALTCS Tribal Case Management page.