MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - August 2016
Arizona Medicaid - AHCCCS·AZ · Emergency Medicine·Claims & Billing
Effective date
Jan 1, 2017
We identified it
Jun 17, 2026
Summary
AHCCCS introduces a new provider type for Free-Standing Emergency Departments (FrEDs) with unique reimbursement methodology effective January 1, 2017. FrEDs must re-register by October 1, 2016, obtain distinct NPIs, and use proper provider type 'ED' for claims to receive correct reimbursement.
Action Required
By October 1, 2016: Free-Standing Emergency Departments must complete new provider registration forms with AHCCCS as provider type 'ED'. Obtain distinct NPIs not already associated with active AHCCCS Provider ID numbers at https://nppes.cms.hhs.gov/NPPES/Welcome.do. Re-register for AHCCCS Online using new FrED NPI and TIN. Ensure all claims for dates of service on/after January 1, 2017 use the FrED NPI as rendering provider. Failure to register may result in provider participation agreement revocation and claims without FrED NPI may be investigated as false claims by AHCCCS OIG.