MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - October 2023
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Oct 1, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS Fee-for-Service has updated billing procedures and contact information for claims, prior authorizations, and documentation requirements. Key changes include new rate schedules effective October 1, 2023, and specific requirements for behavioral health claims documentation that must be submitted within 7 calendar days or claims will be denied.
Action Required
Immediately: Update contact information for AHCCCS services - use (602) 417-7670 for claims and prior auth inquiries, servicedesk@azahcccs.gov for 835 remittance and TIBCO issues. Ensure PWK/Control Numbers exactly match between AHCCCS Online Provider Portal and Transaction Insight Portal for claims with attachments. For behavioral health Provider Types 77, 05, and IC: Submit all required documentation (consent forms, treatment plans, progress notes, medical documentation) within 7 calendar days of claim receipt or claims will be denied. Use specific denial reason codes (AD364, AD075, AD963, AD964, AD965, AD966) to identify missing documentation and submit via Transaction Insight Portal using claim number as attachment number.