MedicaidPrior AuthMedium impact
AHCCCS DFSM Claims Clues - April 2019
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Apr 1, 2019
We identified it
Jun 17, 2026
Summary
AHCCCS introduces new prior authorization requirements for Behavioral Health Residential Facility (BHRF) admissions effective April 1, 2019, requiring 5-day notification and specific documentation. The provider enrollment system is transitioning to an automated online process in fall 2019, and behavioral health billing guidelines are being consolidated into updated manuals.
Action Required
By May 31, 2019: Behavioral health providers must submit authorization requests for all current BHRF patients to maintain coverage. For new BHRF admissions after April 1, 2019: Submit notification within 5 days including behavioral health assessment (not older than 1 year) and treatment plan (not older than 3 months). Use AHCCCS Online Provider Portal for all prior authorization requests. Prepare for transition to new automated enrollment system in fall 2019.