MedicaidAdministrativeHigh impact
AHCCCS DFSM Claims Clues - October 2013
Arizona Medicaid - AHCCCS·AZ·Claims & Billing
Effective date
Jan 1, 2014
We identified it
Jun 17, 2026
Summary
AHCCCS (Arizona Medicaid) is implementing Payment Error Rate Measurement (PERM) reviews starting January 2014, and expanding coverage to include services provided up to 3 months prior to application date. Providers must be prepared to submit documentation for PERM reviews and handle prior quarter coverage billing through AHCCCS Administration.
Action Required
By January 15, 2014: Ensure all current correspondence, payment and service addresses are updated with AHCCCS for PERM contractor contact. Immediately: Update billing workflows to submit prior quarter coverage claims directly to AHCCCS Administration (not managed care contractors) starting January 1, 2014. Stop using CPT 99601 and 99602 for enteral nutrition administration - these are only for specialty drug home infusion. Billing team must refund members for any payments received during approved prior quarter periods and accept AHCCCS payment as payment in full. Failure to provide PERM documentation will result in fund recovery.