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MedicaidAdministrativeMedium impact

AHCCCS DFSM Claims Clues - May/June 2021

Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jan 1, 2022
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS updated their Fee-for-Service prior authorization requirements and billing guidelines for Arizona Medicaid providers. Key changes include extended ROPA registration deadline to January 1, 2022, updated contact information for billing support, and clarified PA requirements for various services including behavioral health admissions, DME over $300, and elective surgeries.

Action Required

Action needed
By January 1, 2022: All referring, ordering, prescribing, and attending (ROPA) providers must complete AHCCCS registration at azahcccs.gov/PlansProviders/NewProviders/ROPA.html. Billing team should verify all ROPA providers are registered and update contact information for prior authorization questions (602-417-4400) and claims customer service (602-417-7670). Review FFS PA Guidelines Online Tool to confirm current prior authorization requirements for services.