MedicaidAdministrativeMedium impact
AHCCCS DFSM Claims Clues - October 2015 Special Edition
Arizona Medicaid - AHCCCS·AZ · Psychiatry·Claims & Billing
Effective date
Oct 1, 2015
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) is integrating physical and behavioral health services for members with Serious Mental Illness (SMI) outside of Maricopa County into single health plans. Members will be reassigned to either Cenpatico Integrated Care or Health Choice Integrated Care based on their county of residence.
Action Required
By October 1, 2015: Billing team must update member eligibility verification systems to reflect new integrated health plan assignments for AHCCCS members with SMI. Verify Cenpatico Integrated Care for members in Cochise, Greenlee, La Paz, Pima, Pinal, Yuma, Santa Cruz, Graham counties and zip codes 85550, 85542, 85192. Verify Health Choice Integrated Care for members in Apache, Coconino, Mohave, Navaho, Yavapai, and Gila counties (except specified zip codes). Failure to verify correct plan assignment may result in claim denials.