MedicaidPrior AuthMedium impact
AHCCCS DFSM Claims Clues - November 2016
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Jan 1, 2017
We identified it
Jun 17, 2026
Summary
AHCCCS is implementing multiple operational changes including delayed payment processing on December 16th, holiday closure on December 26th, new prior authorization requirements for NEMT services over 100 miles effective January 1, 2017, and restricting phone authorization requests to only hospital discharge cases.
Action Required
By January 1, 2017: Billing team must obtain prior authorization before providing Non-Emergency Medical Transportation (NEMT) services for TRBHA members traveling over 100 miles (one way or round trip) to behavioral health services. Submit requests through AHCCCS Online system with valid behavioral health diagnosis. Immediately: Stop requesting phone authorizations except for pending hospital discharges - use web portal or fax with FFS form instead. Plan for one-day payment delays on December 16th and December 26th weeks.