The Arizona Department of Economic Security, Division of Developmental Disabilities (DDD) provides physical and behavioral healthcare services to American Indian/Alaska Natives who qualify for the Arizona Long Term Care System (ALTCS) through a DDD Health Program or its Tribal Health Program (THP). The below table outlines the current options for members:
Option | Physical Health | Behavioral Health | Children's Rehabilitative Services | Long Term Services and Supports | Support Coordination |
---|---|---|---|---|---|
1 | DDD Health Plan | DDD Health Plan | DDD Health Plan | DDD ALTCS | DDD |
2 | DDD Health Plan | Tribal Regional Behavioral Health Authority (TRBHA)* | DDD Health Plan | DDD ALTCS | DDD |
3 | Tribal Health Program | Tribal Regional Behavioral Health Authority (TRBHA)* | Tribal Health Program | DDD ALTCS | DDD |
4 | Tribal Health Program | Tribal Health Program | Tribal Health Program | DDD ALTCS | DDD |
*Where available.
DDD’s THP is a fee-for-service program that allows eligible members to receive services at any AHCCCS registered fee-for-service provider in Arizona.
American Indian/Alaska Native members can also receive physical and behavioral health services from any Indian Health Service (IHS) provider or tribally owned/operated facility at any time without prior approval.
THP members receive assessed Long Term Services and Supports (LTSS), or Home and Community Based Services (HCBS), from one or more DDD Qualified Vendors.
The AHCCCS Division of Fee-for-Service Management (DFSM) administers acute services available through the DDD Tribal Health Program.
Claims for physical, behavioral, or other acute services not listed above provided on or after April 1, 2022, must be submitted to AHCCCS using the AHCCCS online portal.
Fee-for-service providers can get assistance on how to submit completed claims by emailing [email protected].
Guidance related to THP Claims Disputes can be found on the AHCCCS Provider Claims Disputes webpage or in the AHCCCS Fee-for-Service Provider Billing Manual.
Providers with questions related to claims in process and/or billings:
Claim Status – AHCCCS has developed a web application (the AHCCCS Online Provider Portal) that allows providers to check the status of claims online, https://azweb.statemedicaid.us. Customer support for this web application is at 602-417-4451.
If a provider does not have access to the Internet, they may call Claims Customer Service at 602-417- 7670 (option 4), 1-800-654-8713 (In State), or 1-800-523-0231, Ext. 6024177670 (Out of State).
Information regarding submitting claims via the Web – AHCCCS allows providers to submit Professional, Institutional and Dental claims via the AHCCCS website. Visit https://azweb.statemedicaid.us. AHCCCS registered providers must establish a username and password for login purposes if they have not already established one.
Qualified Vendors providing Home and Community Based Services and other long term care supports and services (LTSS) should continue to submit claims to DDD using existing processes.
Providers must request prior authorization for physical, behavioral, or acute services requiring prior authorization using Tribal Health Program Prior Authorization Request Form. Additional information about prior authorization requests and the submission process can be found on the AHCCCS website.
Support Coordinators will continue to provide authorization to Qualified Vendors providing Home and Community Based Services and case management services for DDD THP members.
For additional information on how to use the AHCCCS online portal visit the DFSM Training Resources website.
For prior authorization for certain services and information about these services:
Fee-for-Service providers are encouraged to sign-up to receive updates and information from the AHCCCS DFSM.
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Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification