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AHCCCS Health Plans

Details: Available Health Plans. If you are waiting for your application to be processed or you are not eligible for AHCCCS medical assistance, you may qualify to receive drug and alcohol and mental health treatment services through other funding sources administered by the Regional Behavioral Health

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› Url: http://www.azahcccs.gov/Members/ProgramsAndCoveredServices/availablehealthplans.html Go Now

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Health Plan Report Card

Details: The Health Plan Report Card lets members compare contracted health plans by line of business. This is to let you know, on average: The quality of care members enrolled in each health plan receive, How satisfied members are with their enrolled health plan, and; How well the member’s enrolled health plan met their expectations.

› Verified 6 days ago

› Url: https://azahcccs.gov/Resources/HPRC/ Go Now

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Health Care Advocacy and Advancement

Details: Health Care Advocacy and Advancement. Ensuring that the voice of the community is heard is very important to AHCCCS. AHCCCS has a dedicated division that will interface with members, peers, family members and other stakeholders receiving physical and behavioral health services in …

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› Url: https://www.azahcccs.gov/AHCCCS/HealthcareAdvocacy/ Go Now

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Arizona System of Care

Details: Since July 1, 2016 when the Arizona Department of Health Services, Division of Behavioral Health was incorporated into AHCCCS through Administration Simplification, AHCCCS has been expanding efforts to further the System of Care model to include the adult population, and to incorporate an integrated health perspective. System Oversight Structure

› Verified 5 days ago

› Url: https://www.azahcccs.gov/Resources/OversightOfHealthPlans/SystemOfCare.html Go Now

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Social Determinants of Health

Details: What Are Social Determinants of Health. Social Determinants of Health are the conditions in which a person is born into, grows, lives, works and agesthat impact their health. Social Determinants of Health take into account factors such as the member’s education, employment, physical environment, socioeconomic status, and social support network.

› Verified 9 days ago

› Url: https://azahcccs.gov/Resources/Downloads/DFMSTraining/2021/SocialDeterminantsofHealth.pdf Go Now

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GUIDES AND MANUALS FOR HEALTH PLANS AND PROVIDERS

Details: AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County)

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› Url: http://www.azahcccs.gov/PlansProviders/GuidesManualsPolicies/index.html Go Now

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Arizona Health Improvement Plan

Details: Health Assessment , which highlighted many high-priority issues and inequities. Addressing health equity is more than just a written commitment, it is a commitment to action. Within the Health Equity Action Plan, the action steps identified are focused on how health equity can become operationalized

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› Url: https://www.azahcccs.gov/AHCCCS/Downloads/azhip-2021-2025.pdf Go Now

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About AHCCCS Online Provider Website

Details: AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County)

› Verified 3 days ago

› Url: http://www.azahcccs.gov/PlansProviders/CurrentProviders/AHCCCSonline.html Go Now

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How to Use the AHCCCS Online Provider Portal to Verify

Details: Health care providers are responsible for verifying the eligibility of a member: 1. Each time the member schedules an appointment, and 2. At the time when any physical or behavioral health service is provided. Health care providers must verify the member’s eligibility and enrollment status, including when a member presents an AHCCCS

› Verified 8 days ago

› Url: https://www.azahcccs.gov/Resources/Downloads/DFMSTraining/2020/FALL2020_MemberEligibilityAndVerification.pdf Go Now

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Claims submission using the AHCCCS Online portal.

Details: quality health care for those in need 1 This is the Service Lines screen - fill out all the areas marked by red asterisks 2 Service Dates – Enter the date(s) of service 3 Revenue Code – Enter a Revenue Code 4 Service Unit Count – enter the unit or days you are billing 5 Line Item Charge Amount – Enter the dollar amount that will be

› Verified 9 days ago

› Url: https://www.azahcccs.gov/Resources/Downloads/DFMSTraining/2017/OnLineClaimsSubmission.pdf Go Now

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How to Become a Peer Recovery Support Specialist

Details: The Arizona Health Care Cost Containment System (AHCCCS) is committed to ensuring the availability of timely, quality health care. If you know of an AHCCCS member who is unable to access health services, or if you have a concern about the quality of care, please call your AHCCCS health care plan’s Member Services number.

› Verified 5 days ago

› Url: https://www.azahcccs.gov/AHCCCS/Downloads/PeerRecoverySupportSpecialist.pdf Go Now

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Indian Health Service (IHS), Tribally Operated 638

Details: Indian Health Service (IHS), Tribally Operated 638 Programs, and Urban Indian Health Programs in Arizona . Rev. Dec. 2015 . Phoenix Area Indian Health Service . NAME LOCATION PHONE Phoenix Area IHS Office. Two Renaissance Square 40 N. Central Ave., …

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› Url: https://www.azahcccs.gov/Shared/Downloads/ITUList.pdf Go Now

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American Indian Health Program

Details: American Indian Health Program (AIHP) (Health Plan ID #999998) American Indians and Alaska Natives (AI/AN) enrolled in AHCCCS or Children's Health Insurance Program (KidsCare) may choose to receive their coverage through the AHCCCS American Indian Health Program (AIHP) or one of the AHCCCS-contracted managed health plans called AHCCCS Complete Care Plans ("ACC").

› Verified 2 days ago

› Url: https://azahcccs.gov/AmericanIndians/AIHP/ Go Now

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Apply for AHCCCS Health Insurance/KidsCare

Details: Apply for AHCCCS Medical Assistance/KidsCare. If you are waiting for your application to be processed or you are not eligible for AHCCCS medical assistance, you may qualify to receive drug and alcohol and mental health treatment services through other funding sources administered by the Regional Behavioral Health Authority (RBHA).

› Verified 4 days ago

› Url: https://www.azahcccs.gov/Members/GetCovered/apply.html Go Now

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Telehealth Services

Details: Telehealth is the use of digital technology, like computers, telephones, smartphones, and tablets, to access health care services remotely. AHCCCS members who cannot travel to an office can use these devices from their homes to attend healthcare appointments with their providers.

› Verified 5 days ago

› Url: https://www.azahcccs.gov/AHCCCS/Initiatives/Telehealth/ Go Now

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Welcome to the IHS/638

Details: Indian Health Services contract health (IHS/638 tribal plan). 15 . First and Third Party / Other Coverage AHCCCS has liability for payment of benefits after Medicare and all other first- and third-party payer benefits have been paid. The only way for Medicaid to determine its liability for services is …

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› Url: https://www.azahcccs.gov/AmericanIndians/Downloads/Handouts/Final_IHS_638_Forum11062019.pdf Go Now

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HIE Onboarding Program

Details: HIE Onboarding Program. Health Current, Arizona’s health information exchange organization, offers a range of HIE services designed to integrate member information into care delivery.AHCCCS encourages Medicaid providers to send and receive member health data, referred to as bi- directionally sharing and using clinical information, to better inform providers care decisions.

› Verified 6 days ago

› Url: https://azahcccs.gov/AHCCCS/Initiatives/HIT/onboard.html Go Now

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Welcome to AHCCCS Provider Enrollment

Details: Thank you for your interest in becoming a provider in the AHCCCS program. The Division of Member and Provider Services (DMPS) is responsible for the timely enrollment and revalidation of eligible fee-for-service and managed care health care providers in the AHCCCS program.

› Verified 8 days ago

› Url: https://www.azahcccs.gov/PlansProviders/APEP/ProviderEnrollment.html Go Now

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MILLIMAN REPORT Arizona Health Care Cost Containment …

Details: Health care-related assessments are a common funding source for Medicaid programs nationally and federal financial participation (FFP) is permissible according to the parameters specified in 42 CFR § 433.68. According to Kaiser Family Foundation Health Facts cited in the Medicaid and CHIP Payment and Access Commission’s

› Verified 3 days ago

› Url: https://azahcccs.gov/shared/Downloads/Reporting/ProposedStateRules/AHCCCSDFY2021HEALTHIIAssessmentModelReport.pdf Go Now

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Covered Behavioral Health Services Guide

Details: The AHCCCS Behavioral Health Services has developed a comprehensive array of covered behavioral health services to assist, support and encourage each eligible person to achieve and maintain the highest possible level of health and self-sufficiency. The goals that influenced how covered services were developed include:

› Verified 9 days ago

› Url: https://archive.azahcccs.gov/archive/Resources/Guides%20and%20Manuals/AHCCCS%20Covered%20Behavioral%20Health%20Services%20Guide/covered-bhs-guide.pdf Go Now

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American Indian Health Provider Resources

Details: AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County)

› Verified 7 days ago

› Url: https://www.azahcccs.gov/AmericanIndians/HealthPlans/FeeForService/ Go Now

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ADHS/DBHS Definitions List

Details: Arizona Department of Health Services/ Division of Behavioral Health Services (ADHS/DBHS) | Revised 02/28/2016 5 A Abuse The infliction of, or allowing another person to inflict or cause physical pain or injury, impairment of bodily

› Verified 8 days ago

› Url: https://azahcccs.gov/PlansProviders/Downloads/GM/bhs-definitions.pdf Go Now

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Building an Integrated Health Care System

Details: Building an Integrated Health Care System. Today’s health care system is a series of parts not yet connected to each other. Improving care coordination and communication, while reducing fragmentation, weaves these parts together to create a health care system with more effective outcomes.

› Verified 1 days ago

› Url: https://www.azahcccs.gov/AHCCCS/Initiatives/CareCoordination/ Go Now

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COVID-19 Information

Details: AHCCCS is tracking the latest information we've received from tribes regarding COVID-19 responses and resources. See the Tribal COVID-19 tracking document for hotline numbers, travel restrictions, and general guidance.. If you have other concerns about COVID-19, please call your health plan’s Member Services phone number.

› Verified 2 days ago

› Url: https://www.azahcccs.gov/AHCCCS/AboutUs/covid19.html Go Now

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Case Management Services

Details: health recipient’s treatment plan and thoroughly documented in the progress notes? Faxing referrals to providers This service appears to be an administrative function. Does the service fit the definition* of case management services? Is the service included or part of the behavioral health

› Verified 2 days ago

› Url: https://archive.azahcccs.gov/archive/Resources/Guides%20and%20Manuals/AHCCCS%20Covered%20Behavioral%20Health%20Services%20Guide/AppendixA4.pdf Go Now

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Non-Title XIX/XXI Services

Details: health technicians or behavioral health paraprofessionals. Staff providing the services must have knowledge of state and local landlord/tenant laws. For supported housing services the following billing limitations apply: Supported housing services do not include meals, furnishing(s), cost of

› Verified 1 days ago

› Url: https://www.azahcccs.gov/PlansProviders/Downloads/FFSIHStribalbillingManualDrafts/NonTitle_XIXXXI_Services_Exhibit_19-1_Behavioral_Health.pdf Go Now

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American Rescue Plan Allocations

Details: American Rescue Plan Allocations. AHCCCS is working to implement the recently passed federal law, American Rescue Plan Act of 2021 (ARPA).ARPA is an emergency legislative package to fund vaccinations, provide immediate, direct relief to families impacted by the COVID-19 public health emergency, and support struggling communities.

› Verified 9 days ago

› Url: https://www.azahcccs.gov/AHCCCS/Initiatives/ARPA/index.html Go Now

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AHCCCS ACC and RBHA SMI Enrollment September 1, 2021 By

Details: counties: 1 3 5 7 9 11 29 13 15 17 19 21 23 25 27 pc % health plan: apache cochise coconino gila graham/ greenlee2 lapaz maricopa mohave navajo pima pinal s cruz yavapai yuma totals enrollment care 1st health plan -3,039 10,577 194 - - 109,941 21,610 9,103 - 1,504 - 35,448 - 191,416 10.2%

› Verified 2 days ago

› Url: https://www.azahcccs.gov/PlansProviders/Downloads/Enrol1st.pdf Go Now

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Behavioral Health Residential Facility AHCCCS Medical

Details: Behavioral Health Residential Facilities that are designated as an Indian Health Services (IHS) facility, or a Tribal 638 facility being operated by a Tribe or Tribal organization, do not require prior authorization. No Prior Authorization is required for IHS/638 facilities, for members enrolled under Title XIX.

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› Url: https://www.azahcccs.gov/Resources/Downloads/DFMSTraining/2020/FALL2020_BHRFPolicy320V.pdf Go Now

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Care1st Health Plan Arizona, Inc. and One Care by Care1st

Details: health insurer’s share of net premiums for all U.S. health insurers in the year preceding the assessment. A moratorium suspended the HIF for the 2019 calendar year. The Company incurred health insurer fee of $14,382 and $0, for the years ended December 31, 2020 and 2019, respectively. The HIF has been repealed beginning in 2021. NOTE 3

› Verified 8 days ago

› Url: https://azahcccs.gov/resources/Downloads/ContractorAudits/2020/Care1stHealthPlanArizonaFinalAuditReportF_18349G-1A.pdf Go Now

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CONTACTS CLAIMS CLUES

Details: Fee for Service Members, including those enrolled in the American Indian Health Program (AIHP), Tribal ALTCS, or a TRBHA, should con-tact their doctor, the nearest American Indian Medical Home (AIMH), or the nearest IHS/638 facility. AHCCCS is tracking the latest information we’ve received from tribes regarding COVID-19 responses and resources.

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› Url: https://www.azahcccs.gov/PlansProviders/Downloads/ClaimsClues/2021/January2021ClaimsClues.pdf Go Now

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AHCCCS MEDICAL POLICY MANUAL SECTION 310 COVERED …

Details: a. The physical or behavioral health service for which the transportation is needed is a covered AHCCCS service, b. If the member is not able to provide, secure or pay for their own transportation, and free transportation is not available, and c. The transportation is provided to …

› Verified 6 days ago

› Url: https://www.azahcccs.gov/shared/Downloads/MedicalPolicyManual/300/310-BB.pdf Go Now

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IHS/TRIBAL PROVIDER BILLING MANUAL

Details: Health Resources and Services Administration (HRSA). The only requirement the Tribal 638 Clinic must meet, in order to be recognized as an FQHC by Medicaid, is to be operated by a Tribe or Tribal organization under P.L. 93-638.

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› Url: https://www.azahcccs.gov/PlansProviders/Downloads/IHS-TribalManual/IHS-Chapter20_638_FQHC.pdf Go Now

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Non-Title XIX/XXI FAQs

Details: ensure the health and safety of the member, the provider should contact AHCCCS’ Clinical Resolutions Unit (CRU) at 602-364-4558 or 1-800-867-5808. If the provider believes that there are systemic problems, rather than an isolated concern, the provider should notify the CRU of the

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› Url: https://www.azahcccs.gov/AHCCCS/Downloads/ACC/Non-TitleXIX-XXI_FAQ.pdf Go Now

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IHS/TRIBAL PROVIDER BILLING MANUAL HAPTER LAIM ISPUTES

Details: Arizona Health Care Cost Containment System IHS/Tribal Provider Billing Manual If action on a timely submitted, clean claim fewer than 60 days before the expiration of the 12-month deadline or after the 12-month deadline has passed, the provider will be allowed 60 days from the date of the adverse action to file a claim dispute with OALS.

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› Url: https://www.azahcccs.gov/PlansProviders/Downloads/IHS-TribalManual/IHS-Chap19Grievances.pdf Go Now

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AHCCCS MEDICAL POLICY MANUAL SECTION 310 COVERED …

Details: health care institution according to the health care institution’s policies and procedures that: 1. If the behavioral health services were provided in a setting other than a licensed health care institution, the individual would be required to be licensed as a behavioral …

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› Url: https://azahcccs.gov/shared/Downloads/MedicalPolicyManual/300/310B.pdf Go Now

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Health Insurance Portability and Accountability Act (HIPAA)

Details: The Health Insurance Portability and Accountability Act of 1996 (HIPAA) ensures that qualified individuals are provided continuous coverage for ongoing medical treatment. This may reduce how much or how long a health plan can keep a person from getting coverage due to pre-existing conditions.

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› Url: https://azahcccs.gov/Members/AlreadyCovered/RightsAndResponsibilities/hipaa.html Go Now

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Institutions for Mental Disease (IMD) Overview

Details: quality health care for those in need . CMS’s New Managed Care Rule • New managed care regulations issued July 5, 2016, restrict federal funding for IMD stays to stays of less than 15 days for adults aged 21-64 • Eliminates existing “in lieu” option

› Verified 7 days ago

› Url: https://azahcccs.gov/Resources/Downloads/1115Waiver/InstitutionsForMentalDisease(IMD)WaiverPresentation.pdf Go Now

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ATTENTION: Office Managers / Credentialing Coordinators

Details: registered physicians and other health professionals in all 50 states and the District of Columbia to enter their credentialing information free of charge into a single, uniform online system that meets the credentialing needs of most health plans, hospitals and other healthcare organizations. In April

› Verified 2 days ago

› Url: https://www.azahcccs.gov/Shared/Downloads/News/CredentialingAlliance.pdf Go Now

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TRIBAL BEHAVIORAL HEALTH CONTACT LIST

Details: Behavioral Health Services . 10005 E. Osborn . Scottsdale, AZ 85256 . Pascua Yaqui Tribe. Dr. Yoendry Torres, Psy D. Director of Behavioral Health Services . Centered Spirit Behavioral Health Program . 7490 S. Camino de Oeste . Tucson, AZ 85757 . San Carlos Apache Tribe. Wellness Center Behavioral Health Dept : PO Box O . San Carlos, AZ 85550

› Verified 5 days ago

› Url: https://www.azahcccs.gov/AmericanIndians/Downloads/Procedures/tribes-contact-list.pdf Go Now

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Steward Health Choice Arizona, Inc.

Details: Health Choice’s national health plan operations division, will report to Steve Melody,who will be the Government Operations Officerof BCBSAZ’s Medicaid segment. c. Current audited financial statements of current Contractor and the merging entity. This transaction is a stock purchase and not a merger.

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› Url: https://www.azahcccs.gov/Resources/Downloads/Steward-BCBSAZ/SHCA-BCBSAZ_ACOM_317_Transition_Plan.pdf Go Now

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Tribal Relations

Details: Tribal Consultation. AHCCCS is committed to engaging in open, continuous, and meaningful consultation on a government-to-government basis. The AHCCCS Tribal Consultation Policy (note: pending technical changes and Tribal Consultation) guides the agency’s work and interaction with the Tribal Nations of Arizona.. Learn more about Tribal Consultation at AHCCCS.

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› Url: https://azahcccs.gov/AmericanIndians/TribalRelations/ Go Now

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IHS/638 Facility FAQ’s

Details: A: Home health services must be provided by a Medicare certified Home Health Agency (HHA). For more information on home health, refer to the AMPM chapter 1200 (1240-G). AHCCCS covers medically necessary home health services provided in the recipient's place of residence in lieu of hospitalization.

› Verified 2 days ago

› Url: https://azahcccs.gov/PlansProviders/Downloads/FFSTechnicalAssistance/IHS638_Facility_FAQ.pdf Go Now

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AHCCCS Coordination of Benefits and Third Party Liability

Details: private health insurers provide AHCCCS with the enrollment and claims data necessary to ensure that it is “the payor of last resort.” Implementation • AHCCCS has traditionally contracted with a vendor to provide TPL and COB services. In the past year, AHCCCS competitively rebid

› Verified 8 days ago

› Url: https://archive.azahcccs.gov/archive/Resources/Governmental%20Oversight/Legislative%20Sessions/2009/2009;%2049th%20Legislature,%20First%20Regular%20Session/AHCCCS_TPL-FraudPresentation.pdf Go Now

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