MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - November 2013
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jan 1, 2014
We identified it
Jun 17, 2026
Summary
AHCCCS has revised the Non-Emergency Medical Transportation (NEMT) trip report to include a Date of Birth field, effective January 1, 2014. The policy also outlines common audit findings and billing errors for NEMT claims that result in denials and recoupments.
Action Required
By January 1, 2014: Billing team must update all NEMT trip reports to use the revised format that includes recipient's Date of Birth field. Download updated forms from FFS and IHS/638 Provider Billing Manuals at www.azahcccs.gov. Ensure all trip reports include complete provider information in top left box, accurate odometer readings, recipient signatures, and proper documentation for any mileage variances. Stop using TN modifier for loaded mileage trips originating in Phoenix or Tucson areas. Claims using old trip report format after January 1, 2014 will be denied.