MedicaidPrior AuthHigh impact
AHCCCS DFSM Claims Clues - March 2019
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Apr 1, 2019
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) has updated requirements for behavioral health residential facilities (BHRF), requiring authorization for all AIHP and TRBHA member admissions effective April 1, 2019. Facilities must notify AHCCCS within 5 days of admission and submit proper authorization requests with required documentation or claims may be denied.
Action Required
Immediately: Behavioral health residential facilities (Provider Type B8) must implement new authorization process for AIHP and TRBHA members. Within 5 days of admission: Submit notification to AHCCCS and authorization request with behavioral health assessment and treatment plan. Update billing workflows to ensure compliance with AMPM Policy 320-V and 9 A.A.C.10. Claims will be denied if authorization requests and supporting documentation are not received within the initial 5-day timeframe.