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AHCCCS DFSM Claims Clues - July 2018

Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Oct 1, 2018
We identified it
Jun 17, 2026
Days to comply

Summary

AHCCCS updated procedures for linking claims to attachments between AHCCCS Online Portal and Transaction Insight Portal, requiring exact matching of PWK/Control Numbers and Provider Identifiers. The policy also introduces Integration effective October 1, 2018, consolidating medical and behavioral health services under single health plans.

Action Required

Action needed
Immediately: Billing team must ensure PWK/Control Numbers entered in AHCCCS Online Portal exactly match those in Transaction Insight Portal. Verify Provider Identifiers (NPI or AHCCCS 6-digit ID) match between both portals - if NPI is used in one portal, use NPI in both; if AHCCCS ID is used in one, use it in both. Switch to Transaction Insight Portal for large medical documentation submissions instead of faxing. Always include CRN numbers on all faxed/mailed documentation. By October 1, 2018: Update patient eligibility verification processes for new integrated health plan enrollment structure.