Medical Billing Services in Arizona, Filed Inside Every AHCCCS Deadline

AHCCCS claims must be submitted within 6 months and become clean claims within 12 months of the date of service or the date eligibility is posted, whichever is later. Health plan contracts can set shorter limits. The rule is in Arizona Administrative Code R9-22-703.

AHCCCS (the Arizona Health Care Cost Containment System) is Arizona’s Medicaid program. Most members are enrolled in an AHCCCS Complete Care health plan, and some receive care through AHCCCS fee-for-service.

Six: Arizona Complete Health, Banner–University Family Care, Mercy Care, Molina Healthcare, BCBS of Arizona Health Choice and UnitedHealthcare Community Plan. Which ones a patient can join depends on their county.

Under A.R.S. 20-3102, insurers must adjudicate a clean claim within 30 days and pay the approved amount within 30 days after that, unless a contract says otherwise. Late payments earn interest at Arizona’s legal rate.

Noridian Healthcare Solutions processes Medicare Part A and Part B claims for Arizona as the Jurisdiction F Medicare Administrative Contractor.

Through the AHCCCS Provider Enrollment Portal (APEP). Providers generally revalidate every four years to keep their Medicaid billing privileges. We handle enrollment and revalidation as part of credentialing.

Yes. We bill AHCCCS fee-for-service and all six AHCCCS Complete Care plans, and set up eligibility checks and billing rules for the plans in your county.

Medical billing and claim submission, AHCCCS billing, denial management, A/R recovery, coding and billing audits, provider credentialing, revenue cycle management, remote patient monitoring billing, medical transcription and appointment scheduling.

Most billing companies charge a percentage of collections. eBillingWorks pricing starts at 2.49% and depends on your specialty, claim volume, payer mix and services. You get a written quote after a free audit.

The most common reasons are late AHCCCS submissions, billing the wrong AHCCCS plan, eligibility changes, missing prior authorizations, coding or modifier errors and credentialing gaps.

No. Our team works inside your existing EHR and practice management system.

Yes. We plan the switch with you and work your existing unpaid claims, starting with those closest to their AHCCCS deadline, while new claims flow through our process.

Yes. We work with practices across Arizona, from Phoenix, Scottsdale and Mesa to Tucson, Flagstaff and Yuma.

Yes, when the billing company signs a Business Associate Agreement and protects patient data. We sign a BAA with every client.

We review a sample of your recent claims, denials and aging A/R, then give you a short written summary of what’s working, where money is being lost and what to fix first. There’s no obligation.