PA Submission Process

All authorization requests must include clinical documentation supporting the medical necessity for the services requested.

Primary PA Submission Method

The primary method of submission is the AHCCCS Online Provider Portal. You can also find the link to the AHCCCS Online Provider Portal in the Plans/Providers menu:

Where is AHCCCS Online Link

Prior Authorization Request Submission Process via AHCCCS Online Provider Portal

  1. New users shall set up an AHCCCS online account,
  2. Enter the authorization request via the PA submission link in the AHCCCS online web portal,
  3. Attach required clinical documentation via the online attachment feature,
  4. An authorization number is generated automatically, which will remain in a pending status until an authorization decision is made. A PA confirmation letter is then mailed to the provider indicating the pending authorization status, and
  5. After documentation submitted by the provider has been reviewed and an authorization decision is made, a PA confirmation letter is mailed to the provider indicating the updated authorization status.

Providers can check the status of a submitted authorization request online and view messages from PA staff under the Prior Authorization Inquiry link.

Secondary PA Submission Methods

Prior Authorization Request Submission Process via Fax

Fee-for-Service providers may fax a Prior Authorization request under the following circumstance only;

  • When the provider is unable to submit the PA request due to Internet or electrical outage.
  • Providers must submit the fax request with the required FFS PA request form as the first page of the fax, and include the required clinical documentation.
  • An authorization number is faxed to the provider after information is reviewed, and
  • A PA confirmation letter indicating the authorization status is mailed to the correspondence address on file for the provider.

Providers should not use the Fax method in lieu of creating an AHCCCS Online Provider Portal Account/ID me.

Fax Numbers

  • PA – 602-256-6591
  • UR – 602-254-2304
  • LTC – 602-254-2426
  • BH – 602-253-6695
  • Transport – 602-254-2431

Prior Authorization Request Submission Process via Telephone (reserved for urgent requests after submitting documents through AHCCCS Online Provider Portal or hospital discharges)

An urgent request, as defined in A.A.C. R9-34-306 (B), is one in which following the standard time frame for a request could seriously jeopardize the FFS member’s life or health, or ability to attain, maintain, or regain maximum function.

  1. Following submission of the online urgent request with the required documentation, provider must call the PA line (listed above) to inform PA staff of submission of an urgent request, and
  2. After documentation submitted by the provider is reviewed and an authorization determination is made, a PA confirmation letter is mailed to the provider indicating the authorization status.

Telephone Numbers

  • 1-602-417-7670 (Provider Services)
  • 1-800-523-0231 (Out of state line to AHCCCS switchboard; dial extension 6024174400 or ask for PA area)

Mail

  • AHCCCS-Division of Fee-for-Service Management
    Care Management System Unit (CMSU), Mail Drop 8900
    701 East Jefferson Street
    Phoenix, AZ 85034

In the case of a service denial, termination, suspension, or reduction, notice will be provided in accordance with 9 A.A.C. 34.