MES Modernization Program: July Update
As we turn the calendar to August, it's hard to believe how quickly the year is moving. With each passing month, AHCCCS continues to make meaningful progress on the MES Modernization journey while delivering on our mission every day.
Across the agency, teams are collaborating, solving complex challenges, and reaching important milestones that help strengthen the services and support we provide to members, providers, and partners. This shared commitment to innovation, service, and continuous improvement is what makes transformational efforts like MES Modernization possible.
The progress achieved so far reflects the expertise, dedication, and teamwork of employees across AHCCCS. Together, we are building a stronger, more efficient future that will enhance the experience of those we serve for years to come. Here are some recent updates:
Program Integrity
AHCCCS held an informal webinar for providers on July 16 and shared information about the Alivia 360 platform and the enhanced claim prepayment review process. The webinar explained how the platform supports the identification of potential fraud, waste, and abuse before claims are paid, while maintaining human oversight for all review decisions. Attendees learned who is impacted, what changes to expect, what support resources are available, and how the platform will support a more efficient, data-informed claims review process with minimal disruption to existing submission processes. The webinar slides and recording will be posted on the Program Integrity page soon.
AHCCCS Solutions Center Update
On July 17, the AHCCCS Solutions Center unveiled an updated look and enhanced user experience for external users, including Providers, Health Plans, Members, and the public. The portal link remains the same. These updates were designed to improve navigation and make it easier to access information, while maintaining the current process for submitting and managing requests through the AHCCCS Solutions Center.
Starting August 7, the AHCCCS Solutions Center page will feature a new form called "Access to Care/Eligibility." This form will be accessible to all users, whether logged in or not. This form is designed to submit requests related to a member or applicant's access to care or eligibility status. This can be completed by the Member/Applicant themselves or by a representative. All other functionalities of the AHCCCS Solutions Center will remain the same. Requests will continue to be reviewed and managed by knowledgeable AHCCCS staff, with the same care, attention, and follow-through that Providers, Health Plans, Members, and the public expect. No action is required at this time.
AHCCCS Provider Enrollment Portal (APEP) Changes
Some important enhancements were made to the AHCCCS Provider Enrollment Portal (APEP). New on-screen guidance tools were added to help Providers complete more accurate enrollment applications. A new Online Provider Directory is available to improve visibility for members and providers to see what health plan a provider is contracted with. Lastly, for Limited-risk Providers only, APEP will begin automatically processing certain requests when all system checks are met. There are no changes to existing policy or enrollment processes.
If you have any questions, please use the MES Modernization staff feedback form.
And, if you receive any questions not answered in the newsletter, please direct questions to the public feedback form.
Both forms are anonymous and ask the same questions. The forms can be submitted multiple times asking about different MES Modernization projects. The questions will be answered in newsletters or FAQs – but staff questions and answers will only be made available to internal AHCCCS staff.
In case you missed our previous emails, all information on MES Modernization can be found on the AHCCCS Medicaid Enterprise System (MES) Modernization homepage.
Together, we are building a stronger, more efficient system to serve Arizona’s communities!
