Coverage Types

CRS Services are provided through the CRS Contractor. CRS eligible members will be automatically enrolled with the CRS Contractor according to the chart below.

CRS eligible members will be enrolled under one of the following four CRS coverage types based upon the primary program in which the member is enrolled for acute care services. American Indian (AI) members will be enrolled in the CRS Contractor based on the choice that they make regarding where to receive their acute care and behavioral health services:

Coverage Type	CRS	Acute	BH	Notes	
1.   CRS Fully
Integrated

HP = 010115	X	X	X	Members receiving all services
from the CRS Contractor including acute health, behavioral health and CRS- related services	
2.   CRS
Partially- Integrated – Acute
HP= 010145	X	X		AI members receiving all acute
health and CRS-related services from the CRS Contractor and receiving behavioral health services from a Tribal RBHA.	
3.   CRS
Partially- Integrated – Behavioral Health (BH)

#999125	X		X	CMDP or DDD ALTCS
members receiving all behavioral health and CRS- related services from the CRS Contractor and receiving acute health services from the primary program of enrollment.	
4.   CRS Only

#999135	X			Members receiving all CRS-
related services from the CRS Contractor, receiving acute health services from the primary program of enrollment, and receiving behavioral health services as follows:
•	CMDP and DDD AI
members from a Tribal RBHA
•	AIHP members from a
T/RBHA
CRS Only also includes ALTCS/EPD AI Fee For Service members.	

An AI member’s enrollment choice may be exercised at any time.  These enrollment choices may affect their CRS coverage type.

In general, for CMDP and DDD ALTCS children (also known as coverage type CRS Partially- Integrated – Behavioral Health) CRS provides specialty services related to the member’s CRS condition and all behavioral health services, but does not cover other routine, preventive or acute non-specialized medical services.  For members enrolled in DDD or CMDP, DDD or CMDP remain ultimately responsible for the provision of all AHCCCS covered services to its members including a service denied by the CRS Contractor for the reason that it is not a CRS covered service or a service that is not related to a CRS condition.