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AHCCCS DFSM Claims Clues - August 2023
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Jun 9, 2023
We identified it
Jun 17, 2026
Summary
AHCCCS has implemented a 6-month provider enrollment moratorium for specific behavioral health providers (effective June 9, 2023 through December 9, 2023) and established new documentation requirements for behavioral health claims including consent forms, treatment plans, and progress notes that must be attached to all claim submissions.
Action Required
Immediately: Behavioral health providers must attach required documentation (consent to treat form, comprehensive assessment, treatment plan, and medical records) to ALL behavioral health claims using the Transaction Insight Portal (TIBCO). Create a title sheet identifying each document type when uploading. Billing team must ensure all same-day services are billed on the same claim submission to avoid denials. Provider enrollment staff must stop accepting phone requests for American Indian Health Program enrollment - all requests must now be submitted in writing by fax or email.