Tribal Health Program (THP) Fee-for-Service Provider Resources

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: 

*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 Submissions

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: 

• AHCCCS Claims Customer Service Unit 
• Phoenix area: (602) 417-7670 (Option 4) 
• Out of State: 1-800-523-0231, Ext. 6024177670 (Option 4)

Claim Status – AHCCCS has developed a web application (the AHCCCS Online Provider Portal) that allows providers to check the status of claims online. 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. 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.

Prior Authorization Requests

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: 

• AHCCCS Prior Authorization Unit (Monday - Friday 8:30 a.m. - 4:30 p.m.)
• Phoenix area: (602) 417-4400 
• In State (Outside Maricopa County): 1-800-433-0425 
• Out of State: 1-800-523-0231 Ext. 6024174400 (or ask for the PA area) 
• Fax # (general) - (602) 256-6591 
• Fax # (transportation providers only) – (602) 254-2431

Fee-for-Service providers are encouraged to sign-up to receive updates and information from the AHCCCS DFSM.

Frequently Asked Questions (FAQ)

THP Transition Provider FAQs