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  • Phoenix Health Plans Prior Authorization Form

Get Phoenix Health Plans Prior Authorization Form

Phone: (602) 824- 3900 (888) 864- 1114 PRIOR AUTHORIZATION REQUEST FORM SELECT WHICH HEALTH PLAN YOU ARE REQUESTING AUTHORIZATION PHOENIX HEALTH PLAN (AHCCCS) FAX # (602) 674- 6678 PHOENIX ADVANTAGE.

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Eligibility – status of pending application, determination results, Processing Period If the customer is applying for:Then the processing period is...All other programs45 calendar days from the application date5 more rows

Income information is first collected from the Federal and State Data Services Hubs, if available, and compared to the income reported by the customer. When the customer reports income that is over the income limits for AHCCCS Medical Assistance (MA), it is reasonably compatible. No further proof is needed.

Income Limits Household SizeGross Monthly Income Limit Effective 02/01/20231$1,2882$1,7423$2,1964$2,6502 more rows

To qualify for AHCCCS, most people must meet several basic requirements: Be under 65 years old. You can be 65 or older if you are the parent or caretaker of a child. Not be eligible for Medicare. ... Be a U.S. citizen or meet specific noncitizen requirements, and. Have income below certain limits.

Contact Us For Online Provider Enrollment/Application Payment Questions: Call: Maricopa County: 602-417-4254. Statewide: 1-888-827-4420. Write: AHCCCS Provider Enrollment Fee. 701 E. Jefferson, MD 5400. Phoenix, AZ 85034.

AHCCCS is Arizona's State Medicaid Program. AHCCCS Members who also have Medicare are called Dual Eligible Members. Being enrolled in the same health plan for Medicare and Medicaid is called “alignment.”

AHCCCS is the secondary payer to Medicare. This means that for members with Medicare, that Medicare is the primary coverage for that member. Providers must submit claims to Medicare first, prior to billing AHCCCS.

Income Limits Household SizeGross Monthly Income Limit Effective 02/01/20231$1,2882$1,7423$2,1964$2,6502 more rows

The member does not require a referral from the PCP to see a behavioral health medical provider. Members who are AHCCCS eligible and are also American Indian may access behavioral health services through the Tribal Regional Behavioral Health Authority (TRBHA) or Indian Health Service Facilities.

Founded in 1982, the Arizona Health Care Cost Containment System (written as AHCCCS and pronounced 'access') is Arizona's Medicaid program, a federal health care program jointly funded by the federal and state governments for individuals and families who qualify based on income level.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232