B Application Processing

Revised 09/16/2025

Policy

The customer, or someone acting on the customer’s behalf, may start the application in a variety of ways as described in the following table:

When the application is made for...	Then the application may be started by...
Arizona Long Term Care System	The customer or representative by: Online through Health-e-Arizona Plus (HEAplus); Mail; Phone; Email; Fax; Visiting a local ALTCS or AHCCCS office; or Home visit.
Breast and Cervical Cancer Treatment Program	One of the Arizona National Breast and Cervical Cancer Early Detection Programs (AZ-NBCCEDP) programs by: Mail; Email; or Fax.
Any other AHCCCS Medical Assistance program	The customer or representative by: Online through Health-e-Arizona Plus (HEAplus); Phone; Email; Fax; Visiting a local AHCCCS or DES-FAA office; or Visiting a participating assistor office.

See the following links to find a local office:

DES-FAA: https://des.az.gov/find-your-local-office
ALTCS: https://azahcccs.gov/Members/ALTCSlocations.html
AHCCCS: https://www.azahcccs.gov/shared/AHCCCScontacts.html

1) Application Date

The application date is determined as follows:

When the application is for...	And the signed application is received...	Then the application date is...
Any program	By Health-e-Arizona Plus (HEAplus)	The date the application is submitted in HEAplus.
	By mail	The date the application is received by any of the following: AHCCCS local office; ALTCS local office; DES-FAA local office; or Outreach site designated to accept AHCCCS Medical Assistance applications.
	By phone	The date the application is received over the phone.
	By email	The date the application is received by any of the offices listed above, even when received afterhours, on a weekend, or a holiday.
	By fax	The date the application is received by any of the offices listed above, even when received afterhours, on a weekend, or a holiday.
	By visiting a local office	The date the person delivers the application to a local office.
	By a Community Assistor	The date the application is signed and dated; or The date the application is received when the application is not dated.
	From a hospital for a hospitalized customer	The date the application is signed and dated; or The date the application is received by AHCCCS when the application is not dated.
BCCTP	From an Arizona National Breast and Cervical Cancer Early Detection Program (AZ-NBCCEDP)	The date the diagnostic procedure was performed that confirmed a diagnosis of breast cancer, cervical cancer, or a pre-cancerous cervical lesion. NOTE This date will be earlier than the date the application is received.
ALTCS	During a home visit	Date of the home visit.

NOTE An application may be accepted without a signature. However, the application must be signed by an authorized person before it can be approved.

2) Missing Customer Information

When an application is received with missing information, the eligibility worker will attempt to get the information electronically. If the information is not available electronically, a request for information will be sent to the customer.

3) Processing Period

The processing period begins the day of the application date and ends on the date that the decision has been made and the customer is notified.

Expedited processing requests should only be made if:

The application is already submitted, and
All pending verifications are available in HEAplus, and
The applicant meets one of the below criteria:
- Requires an immediate hospital admission due to a medical condition; or
- Requires immediate admission to a behavioral health treatment center

NOTE If the person is currently in a hospital, then the hospital question should be answered "Yes"; which will trigger routing to the appropriate unit for processing.

4) Decision Letters

Each person that applies for MA must receive a letter explaining the decision on their application. The decision letter is available electronically as soon as the decision is processed.

Letters must be sent to the following persons:

The customer;
The customer’s legal representative; and
The customer’s authorized representative when the customer and representative do not live together.

5) Requests for Information

A letter is sent to the customer when more information is needed to make a decision. Customers are given at least 15 days from the date of the letter to provide the requested information.

6) Processing Period Extensions

The application processing period may be extended beyond the processing time frame and the Benefits and Eligibility Specialist and customer must continue to take all actions needed to get the information when any of the following conditions are met:

A Policy Clarification Request (PCR) is needed that will affect the eligibility decision;
A Disability Determinations Services Administration (DDSA) decision is pending; or
The customer requests a one-time five-day extension beyond the processing time, to get documentation or proof needed for the eligibility decision.

Definitions

Term	Definition
Calendar Day	Any day in the month. This includes weekends and holidays.
Working Day	Any day Monday through Friday, excluding federal and state holidays.

Timeframes

When the customer is applying for:	Then the processing period is...
SSI-MAO or FTW based on disability	90 calendar days from the application date
KidsCare	30 calendar days from the application date
BCCTP	7 calendar days from the date a complete application is received by AHCCCS.
All other programs	45 calendar days from the application date Exceptions: 20 calendar days from the application date when the customer is pregnant 7 calendar days from the application date ONLY when the customer is hospitalized AND no proof or other information is needed for the determination

Legal Authority

Program

Legal Authorities

All Programs

42 CFR 435.907

42 CFR 435.912

42 CFR 457.340 (KidsCare)

AAC R9-22-1413(A)

AAC R9-22-2006(A)