Division%20of%20Fee For Service%20Management%20Update 1 20 16.Pdf Form

Division of Fee-for-Servi Division of Fee-for-Service Management Update Tribal Consultation January 20, 2016

AIHP Care Coordination
AIHP Care Coordination
• High Need/High Cost Initiative

• Flagstaff Medical Center Initiative

• Data Sharing Efforts

• Building Relationships 2 Reaching across Arizona to provide comprehensive
quality health care for those in need

AIHP Payments for Services (in milli AIHP Payments for Services (in millions) 0 100 200 300 400 500 600 700 800 900 1000 FY 13 FY 14 FY 15 Non-Tribal Uncomp Services 3 Reaching across Arizona to provide comprehensive
quality health care for those in need

4 1 100% Federal Indian Health Services & Tribal Facility Payments (In Millions) 0 100 200 300 400 500 600 FY 04 FY05 FY 06 FY 07 FY 08 FY 09 FY 10 FY 11 FY 12 FY 13 FY 14 FY 15

TRBHA Transition TRBHA Transition • Point of Contact-Markay Adams

• DBHS Staff

• Outreach Meetings

• IGA Development 5 Reaching across Arizona to provide comprehensive
quality health care for those in need

Tribal ALTCS Transition Tribal ALTCS Transition • Point of Contact- Denise Taylor-Sands

• Tribal ALTCS Staff

• Audits and Reviews

• Daily Operations 6 Reaching across Arizona to provide comprehensive
quality health care for those in need

State Innovation Model (SIM) Grant State Innovation Model (SIM) Grant • Care Coordination Workshop(s)

• Stakeholder Groups- Data Sharing

• Health Information Exchange

• Letter to IHS Headquarters 7 Reaching across Arizona to provide comprehensive
quality health care for those in need

Claims and Policy Claims and Policy • Claims Administration Staff Changes • Training Resources (see attachment) • IHS/638 Quarterly Forum
• NEMT Tribal Broker RFI • Audits (see attachment)

8 Reaching across Arizona to provide comprehensive
quality health care for those in need

Contact Information for Prior Autho Contact Information for Prior Authorizations and Claims 9 Reaching across Arizona to provide comprehensive
quality health care for those in need FFS Prior Authorization Contact Number: 602-417-4400 AHCCCS Website web portal: https://azweb.statemedicaid.us/
Once they log in, select Prior Authorization Inquiry FFS Claims Customer Service Number: 602-417-7670, Option 4 AHCCCS Website web portal: https://azweb.statemedicaid.us/
Once they log in, they can status claims, check eligibility and enrollment, submit claims etc.
FFS Behavioral Health Claims Customer Service: 602-417-7670, Option 4 AHCCCS Website web portal: https://azweb.statemedicaid.us/ Once they log in, they can status claims, check eligibility and enrollment, submit claims etc.

Contact Information Contact Information • Elizabeth Carpio, Assistant Director DFSM AHCCCS E-mail: Elizabeth.Carpio@azahcccs.gov • Anne Dye, Deputy Assistant Director

E-Mail: Anne.Dye@azahcccs.gov

• Denise Taylor-Sands, Tribal Health Care Administrator
E-mail: Denise.Taylor-Sands@azahccs.gov • Markay Adams, Behavioral Health Administrator E-mail: Markay.Adams@azahcccs.gov • Albert Escobedo, Interim Claims Administrator

E-mail: Albert.Escobedo@azahcccs.gov

Thank You. Thank You. 11 Reaching across Arizona to provide comprehensive
quality health care for those in need