MedicaidPrior AuthMedium impact
AHCCCS DFSM Claims Clues - April 2016
Arizona Medicaid - AHCCCS·AZ · Psychiatry, Dentistry·Claims & Billing
Effective date
Jul 1, 2016
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) is implementing two major changes: 1) Starting July 1, 2016, behavioral health authorization requests for TRBHA members must be faxed directly to DFSM at 602-364-4697, and 2) Starting August 1, 2016, dental services under deep sedation/general anesthesia will switch from prior authorization to retrospective review with required documentation submitted with claims.
Action Required
By July 1, 2016: Behavioral health providers must redirect all TRBHA authorization requests to fax 602-364-4697 using the FFS Authorization Request form as coversheet, selecting BHS and TRBHA as document type. By August 1, 2016: Dental providers performing services under deep sedation/general anesthesia must stop submitting prior authorizations and instead submit claims electronically with required documentation (substantiation of necessity, treatment plan, radiographic images). Continue submitting prior authorizations 7 days in advance for removable prosthetics, cast crowns, orthodontia, and pre-transplant dental services.