IMAGES

  1. Fillable Online SAFETY INSPECTION CHECKLIST FORM

    ahcccs site visit checklist

  2. Arizona Ahcccs Daily Trip Report

    ahcccs site visit checklist

  3. Site Analysis Site Visit Checklist

    ahcccs site visit checklist

  4. Construction Site Inspection Checklist Template Doc

    ahcccs site visit checklist

  5. Fillable Online azdhs AHCCCS Application Checklist /Coversheet

    ahcccs site visit checklist

  6. What Is A Construction Site Visit Report Template?

    ahcccs site visit checklist

COMMENTS

  1. PDF Provider Office Checklist

    Provider Office Checklist Here is a checklist to prepare your office for working with AHCCCS. Do you know that all AHCCCS registered providers can provide services for and bill for ... a. If so, email [email protected] or visit the Fee-For-Service Provider Training webpage, which contains online tutorials and presentations

  2. Electronic Visit Verification (EVV) Website

    Pursuant to Section 1903 of the Social Security Act (42 U.S.C. 1396b), also known as the 21st Century Cures Act, in order to prevent a reduction in the Federal Medical Assistance Percentage (FMAP), AHCCCS is mandated to implement Electronic Visit Verification (EVV) for non-skilled in-home services (attendant care, personal care, homemaker, habilitation, respite) and for in-home skilled nursing ...

  3. AHCCCS Medical Policy Manual (AMPM)

    The AHCCCS Medical Policy Manual (AMPM) provides information to Contractors and Providers regarding services that are covered within the AHCCCS3 program. The AMPM is applicable to both Managed Care and Fee-for-Service members. The AMPM should be referenced in conjunction with State and Federal regulations, other Agency manuals [AHCCCS Contractors' Operations Manual (ACOM) and the AHCCCS Fee ...

  4. PDF AHCCCS IOC Site Visit Suggestions

    Safety and Security. At least two (2) IOC members on any site visit, not to exceed a quorum to prevent Open Meeting Law violation. Guidelines should include protocols for members to follow when conducting site visits. IOC members must provide proper identification as an identification of active member status (ADOA provides)

  5. PDF 2024 VFC Program Operations Guide Final

    Failure to comply with Arizona VFC program requirements as described in this operations guide will result in progressive disciplinary actions. Follow-up visits will occur throughout the process. The terms "fraud" and "abuse" related to VFC are consistent with the definitions in Medicaid regulations (42 CFR §445.2).

  6. PDF On-Site Program Monitoring Visits and Life Safety Inspections

    Transmital Date - 04/26/2021. The DDD On-Site Program Monitoring Visits and Life Safety Inspections of all service setings will resume the week of May 3, 2021. All visits will be conducted following CDC and ADHS COVID-19 protocols, including wearing masks and social distancing.

  7. Credentialing and Re-Credentialing Requirements

    The initial credentialing process includes verification of information submitted on the credentialing application and a site visit (if applicable), and is completed before the effective date of the initial contract. An application must be complete, signed, and dated. Credentials with expiration dates must be valid at the time of approval.

  8. PDF Site Visit Checklist

    Site Visit Checklist Name of Center or Family Home Provider: Phone Number: Address: Check here Clean, colorful and in good repair Safe places to play both inside and outside Child proofing (medicine out of reach, cleaners in locked cabinets, covered electrical outlets) Emergency procedure plans are posted

  9. PDF Member Handbook AHCCCS Complete Care (ACC)

    Covered services are funded under contract with AHCCCS. 2 Arizona Complete Health-Complete Care Plan Member Services 1-888-788-4408, TTY/TDY: 711

  10. PDF Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

    Early and Periodic Screening, Diagnostic and Treatment Program (EPSDT) is Medicaid's federally mandated comprehensive child health program of prevention, treatment, correction, and improvement of physical and behavioral/mental health conditions for AHCCCS members up to 21 years of age. A well‐child visit is synonymous with an EPSDT visit.

  11. AHCCCS Provider Enrollment Applications and Revalidations

    For more information visit the National Plan and Provider Enumeration System (NPPES) webpage at https://nppes.cms.hhs.gov or contact the NPI Enumerator at 1-800-465-3203 or TTY 1-800-692-2326. Completed W9 Tax Form - Request for Taxpayer Identification Number and Certification - Any provider who will be receiving state/federal funds for ...

  12. PDF Behavioral Health Residential Facility Initial Checklist

    Title 9, Chapter 10, Article 1 (General) Title 9, Chapter 10, Article 7 (Behavioral Health Residential Facilities) This checklist is a tool for use in preparing for an initial inspection and does NOT contain all applicable regulations (rules and statutes) that govern the licensure of Behavioral Health Residential Facilities.

  13. PDF CO HCBS Final Rule Settings Site Visit Checklist

    Goal of the HCBS Final Rule Site Visit Checklist This site visit checklist is designed to help guide the site visit team's assessment of each provider's compliance with the final rule. The checklist below is divided into three sections: rights and autonomy, informed choice, and community integration and institutional characteristics. These ...

  14. Log In

    For assistance with the APEP portal, please visit the Provider Enrollment site, or contact Provider Services at (602) 417-7670. ID.me account now required! AHCCCS partnered with ID.me to provide secure identity verification and login services to its users. As of January 4, 2024, you are required to use ID.me to access the AHCCCS Online portal.

  15. PDF LCR-1027C

    Your application packet should include: Application for Initial HCBS Certification (LCR-1025) Qualified Vendor Registration (LCR-1027B) Copy of the Fingerprint Clearance Card (FCC) issued by the Arizona Department of Public Safety (DPS) for the CEO/President/Owner. If the FCC is pending, you may enclose a copy of the FCC Application (DPS-802 ...

  16. PDF ADHS-BHS COVERED SERVICES GUIDE

    A request for change to the AHCCCS BEHAVIORAL HEALTH Covered Services Guide may be made by representatives of AHCCCS BEHAVIORAL HEALTH SERVICES, the T/RBHAs or their contractors, persons and/or their families, advocates or other state agencies/stakeholders. Written requests should be forwarded to the AHCCCS BEHAVIORAL HEALTH SERVICES at

  17. AHCCCS Provider Revalidation

    AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Phone: 602-417-4000 Toll Free: 1-800-654-8713

  18. Health Center Program Site Visit Protocol

    The Site Visit Protocol (SVP) is a guide to the operational site visits (OSVs) we conduct at health centers. It includes what we look for and how we assess compliance. It aligns with the Health Center Program Compliance Manual. Changes made to the SVP. In 2023, we improved the format of the SVP and made it easier to read.

  19. Checklist for Site Visit f

    Checklist for Site Visit f - Free download as Word Doc (.doc / .docx), PDF File (.pdf), Text File (.txt) or read online for free.

  20. PDF Hcbs Settings Compliance Checklists

    Page 2 of 52 Revised May 2023 What This Looks Like in Practice • People who live in the home can come and go even if the front door is locked (e.g., ring a bell, have their own key or request a key prior to leaving). • Locks are standard on all bedroom unit doors, and people who live in the home can choose whether to use them. • People have control over their privacy and the option to ...

  21. PDF Provider Enrollment Form

    Provider Enrollment Form - AHCCCS ... of

  22. PDF Health Center Program Site Visit Protocol: Consolidated Documents Checklist

    Consolidated Documents Checklist. NOTE: This resource complements the Site Visit Protocol (SVP), which is the primary tool for assessing compliance with Health Center Program requirements during Operational Site Visits (OSVs). Refer to the Health Center Program Compliance Manual as the principal resource to assist health centers in ...

  23. Home and Community Based Settings (HCBS) Rules

    In 2015, AHCCCS began working with a wide range of stakeholders representing the long-term care community to assess the State's compliance with the HCBS Rules and identify further opportunities to enhance member integration experience and outcomes by building off Arizona's long-standing history of the provision of Home and Community Based Services.