P1108 How to Pre-Enroll a Customer in an AHCCCS Health Plan
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P1108 How to Pre-Enroll a Customer in an AHCCCS Complete Care (ACC) Plan

 

Program

Manual Section

ALTCS

AHCCCS FTW-ALTCS

MA1108

MA1503

 

Procedures

Follow the instructions below to pre-enroll a customer in an AHCCCS Complete Care (ACC) plan when the customer’s ALTCS eligibility is ending, but he or she remains eligible for an acute program:

Step

Action

1

Calculate 90 days back from the effective date of the ALTCS discontinuance.

2

Check PMMIS to see if the customer was enrolled with an AHCCCS Complete Care (ACC) plan during the 90-day period.

  • If YES, STOP. You do not need to pre-enroll the customer in an acute plan.

  • If NO, continue to step 3.

3

Use the health plan listing in MA1102 or the Available Health Plans listing on the AHCCCS website to find the health plans available in the county where the customer lives.

NOTE     In addition to the other available acute plans, American Indians also have the option of enrolling with AIHP.

4

Inform the customer of the opportunity to choose a health plan and the options available.

NOTE     Do not make any recommendation on health plan choice.

5

Call Enrollment Services at (602) 417-7100 on or before the effective date of discontinuance and provide the customer’s:

  • Name;

  • Date of birth;

  • Social Security Number; and

  • Health plan choice.

6

Document pre-enrollment action in the case comments.