AHCCCS Technical Interface Guidelines (TIG)

 

Recipient Interface

Introduction - The automated IVR system at Arizona Health Care Cost Containment System (AHCCCS) is a process that provides recipient eligibility verification services to AHCCCS providers. Providers can obtain specific eligibility, enrollment, Medicare and other third party data without using the AHCCCS Communications Center.

Schedules - IVR is available 24 hours a day, and is limited only by downtime scheduled at the ADOA-DC mainframe and the recycling of AHCCCS' production CICS region. These downtimes are normally scheduled from 4:00 a.m. to 4:15 a.m. daily, from midnight Friday to 7:00 a.m. Saturday, and from midnight Saturday to 7:00 a.m. Sunday.

Media - IVR is accessed via any touch-tone phone. A local number and a 1-800 toll-free number are available to all contracted providers.

Reporting - AHCCCS has automated paper trails to aid in problem diagnosis. Some areas in the state are offered the option of receiving faxed copies of the verification information to be used for record keeping, or as an audit trail.

Testing - AHCCCS is responsible for all marketing, training, and testing of the IVR system.

Introduction - The WEB Based Verification at Arizona Health Care Cost Containment System (AHCCCS) is an internet-based process to provide member eligibility verification of services to AHCCCS registered Providers. Providers can obtain specific eligibility, enrollment, Medicare, other Third Party Liability and claims data without using the AHCCCS Communication Center or IVR.

Schedules - The WEB Based Verification is available 24 hours a day, and is limited only by downtime scheduled at the ADOA-DC mainframe and the recycling of AHCCCS' production CICS region. These downtimes are normally scheduled from 4:00 a.m. to 4:15 a.m. daily, from midnight Friday to 7:00 a.m. Saturday, and from midnight Saturday to 7:00 a.m. Sunday.

Media - The WEB Based Verification is accessed via the internet. Registration is required. The application can be accessed from the AHCCCS Online website.

Reporting - Summary reports are produced to reflect the number of new accounts created, eligibility inquiries, and claim inquiries made during the month.

Testing - AHCCCS is responsible for all marketing, training, and testing of the WEB Based Verification process.

Introduction - The 270/271 Verification at Arizona Health Care Cost Containment System (AHCCCS) is a batch and internet-based process to provide member eligibility verification of services to AHCCCS registered Providers. Providers can obtain specific eligibility, enrollment, Medicare, other Third Party Liability and claims data without using the AHCCCS Communication Center or IVR.

Schedules - The 270/271 Verification is available 24 hours a day, and is limited only by downtime scheduled at the ADOA-DC mainframe and the recycling of AHCCCS' production CICS region. These downtimes are normally scheduled from 4:00 a.m. to 4:15 a.m. daily, from midnight Friday to 7:00 a.m. Saturday, and from midnight Saturday to 7:00 a.m. Sunday.

Media - The 270/271 Verification is accessed via the internet. Registration is required.

Reporting - Summary reports are produced to reflect the number of new accounts created, eligibility inquiries, and claim inquiries made during the month.

Testing - AHCCCS is responsible for all marketing, training, and testing of the 270/271 process.