01Elapsed June 1, 2021 deadline: Providers who refer, order, prescribe or attend for AHCCCS members must be registered with AHCCCS to be reimbursed, so the billing team should confirm the registration status of referring and ordering providers on claims and check current applicability before acting.
02Elapsed April 1, 2021 hard edit: Claims for EVV services will not be paid unless all required EVV visit data is present, so the billing team must confirm EVV visit data is complete before submitting EVV claims.
03CMS-1500 claims: Keep data in the correct fields, do not include stamps, copies, correction fluid or correction tape, and enter diagnosis codes in order starting with field A, because claims that fail AHCCCS requirements are returned as un-processable.
04Resubmit corrected claims electronically as a new claim, using the preferred font of Lucinda Console size 10.
05Telephonic services: Providers must list Place of Service 02 when services are provided telephonically, including codes 98966, 98967, 98968, 99441, 99442, 99443, H0025, H0038, H2014, H2025, S5110 and T1016.
06Prior authorization: Submit Fee-for-Service prior authorization requests through the AHCCCS Online Provider Portal, attach supporting documents there, and do not include modifiers on the PA submission except modifier 50.
07NEMT: Bill wait time with HCPCS T2007 in 30 minute units only when the driver actually waited at the medical service destination, do not bill a transport when the medical appointment is cancelled, do not submit claims for unloaded mileage, and make billed miles match the odometer readings on the Daily Trip Report.
08Do not bill for picking up a prescription on the member's behalf, and do not bill a transport if the prescription was not ready and not delivered to the member.