MedicaidAdministrativeMedium impact
AHCCCS DFSM Claims Clues - December 2013
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Feb 1, 2014
We identified it
Jun 17, 2026
Summary
AHCCCS has updated requirements for the 2014 PERM cycle review process and revised the Non-Emergency Medical Transportation (NEMT) trip report to include recipient Date of Birth field. The new NEMT form will be mandatory for all services on or after February 1, 2014.
Action Required
By February 1, 2014: Billing team must update all Non-Emergency Medical Transportation (NEMT) trip reports to include the recipient's Date of Birth field. Download the revised form from the FFS and IHS/638 Provider Billing Manuals. Ensure all NEMT claims submitted for services on or after 2/1/2014 use only the new format. Old format submissions will be rejected after this date.