Dispute Claim Form With Insurance Company In Maricopa
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FAQ
Original claim forms must be used for any paper claims submitted to AHCCCS. claim form. To ensure the successful processing of a paper claim form: Claim forms with labels and stamps will not be accepted, as that is considered an alteration of the claim.
Timely submission New claims: File claims with a valid claim form within 150 days from the date you performed services or from the date of eligibility posting, whichever is later.
Appeals must be filed with the RBHA (or AHCCCS for the TRBHAs) and must be initiated no later than 60 days after the decision or action being appealed. Appeal forms are available at AHCCCS, the T/RBHAs, case management sites and at all provider sites.
Timely submission New claims: File claims with a valid claim form within 150 days from the date you performed services or from the date of eligibility posting, whichever is later.
Things to Include in Your Appeal Letter Patient name, policy number, and policy holder name. Accurate contact information for patient and policy holder. Date of denial letter, specifics on what was denied, and cited reason for denial. Doctor or medical provider's name and contact information.
Timely Filing guidelines: 120 days from date of service. Claims can be submitted via: Secure Portal.
The Maricopa County Justice Courts have exclusive jurisdiction over all small claims filings within Maricopa County. In the justice court you may file a Small Claims lawsuit claiming an amount UP TO AND INCLUDING, $3,500.00.
If you are not sure whether the Arizona Department of Insurance is the right place for your question or problem, contact our Consumer Protection Division: Phone: (602) 364-2499. Phone Hours: a.m. and p.m., Mondays through Fridays (except state holidays) Email: insurancensumers@difi.az.
Every county in Arizona has at least two justice courts. The justice courts have exclusive authority to hear cases in which the amount in controversy is $10,000 or less. Cases in which the amount in controversy is greater than $10,000 must be filed in the superior court.
Any individual, partnership, association or corporation may file a small claims suit for a situation in which the dispute is for $3,500 or less. Attorneys are not allowed in small claims court unless both parties agree.
