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Billing under a signed BAA
Arizona medical billingUSA

Medical billing services in Arizona

Arizona practices lose more money to AHCCCS plan rules and prior authorization than to anything a coder gets wrong. We work your claims inside the system you already use, chase the ones that stall, and appeal the ones that should never have been denied.

  • AZBilled end to end
  • 7+Plans commonly billed
  • 50+Specialties covered
Arizona clinicians and billing specialists working the state-specific payer workflow
The local problem

What actually goes wrong with Arizona claims

These are important areas to check when configuring a Arizona billing workflow. The applicable plan and date of service determine the requirements.

  • AHCCCS plan rules, not one rule

    Each contracted plan publishes its own prior authorization list and its own filing deadline. Billing all of them as though they were one payer is where Arizona practices quietly lose claims.

  • Prior authorization turnaround

    Imaging, infusion and behavioral health carry the heaviest authorization load here. We track every request to a decision rather than filing it and hoping.

  • A large Medicare Advantage population

    Retirement counties shift the payer mix hard toward Advantage plans, which means plan specific documentation and more aggressive medical necessity review.

Medicaid

AHCCCS billing

Arizona Health Care Cost Containment System.

Arizona runs its Medicaid program almost entirely through managed care plans, so a single AHCCCS patient can mean Mercy Care, Banner University Family Care or Health Choice Arizona rules depending on enrollment. The plan decides the prior authorization list and the timely filing clock, not AHCCCS itself.

Payer mix

Plans an Arizona practice bills

These are plans operating in Arizona. Your account is configured for the ones you actually see, not a statewide average. If yours is not listed, ask.

Blue Cross Blue Shield of ArizonaUnitedHealthcareAetnaCignaBanner Health plansMercy CareHealth Choice Arizona
Local workflow

Before a Arizona claim is submitted

Configure the work around AHCCCS and the plans your practice actually sees.

  • Confirm the member plan and billing destination for each date of service.
  • Check provider enrollment, service location and authorization requirements.
  • Use the applicable filing and appeal deadlines in the claim worklist.
  • Reconcile payments against the relevant contract or fee schedule.
Coverage

Serving practices across Arizona

We work remotely inside your practice management system, so where you sit inside the state does not change what we can do. These are simply where Arizona practices most often are.

PhoenixTucsonMesaChandlerScottsdaleGlendaleGilbertTempePeoriaSurprise
Questions

Arizona billing questions

Do you bill AHCCCS and its managed care plans?

Yes. We work AHCCCS claims through whichever contracted plan the patient is enrolled in, and we follow that plan’s authorization list and filing deadline rather than treating AHCCCS as a single payer.

We are in Phoenix and use a system you did not list. Can you still work it?

Almost certainly. We log into your practice management system rather than moving you onto ours, and the systems listed on this site are the common ones, not the only ones. Ask and we will confirm.

How fast can you start on our Arizona A/R?

We start with a review of the last ninety days of claims data before any commitment. That tells you where money is actually stopping, and it tells us what to work first.

Do you handle prior authorization as well as billing?

Yes. Prior authorization management is one of our services, and in Arizona it is usually the single highest value thing we take off a practice’s desk.

Next step

Find out what Arizona payers owe you

Tell us your specialty and the billing issue you want reviewed. We will agree the scope and arrange a secure way to share any records needed.

Get a free A/R review
A clearer picture of your A/R

Get a free A/R review

Tell us about your practice. We will get in touch to discuss your receivables and the next step. Please do not include patient information.

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What is going wrong in your billing right now?

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