P1702 How to Process an Appeals Request

Programs	Manual Section
All Programs	MA1702

The following sections describe:

How to process appeal requests received in writing (paper or electronic);
How to process an appeal request received over the phone; and;
How to process a customer’s request to have someone represent the customer at the hearing.

When you receive a written appeal request, including email or fax requests, take the following actions:

Step	Action
1	Upload a copy of the hearing request to DocuWare (for ALTCS cases) or HEAplus (for non-ALTCS cases).
2	Email your Agency’s appeals office. Attach a copy of the hearing request. AHCCCS: DMPSEligibilityHearings@azahcccs.gov DES: OIG.PA.Appeals@azdes.gov
3	Schedule the Pre-Hearing Discussion. See Pre-Hearing Discussion Procedures for more information.

Follow the steps below when a customer calls the eligibility office to request an appeal.

Step	Action
1	Explain the timeframes and deadlines for the appeal process. If the customer would like to continue to receive benefits during the appeal process, explain that the customer must request this before benefits are stopped.
2	Complete or schedule the Pre-Hearing Discussion when possible. See Pre-Hearing Discussion Procedures for detailed steps.
3	AHCCCS Staff: Complete a Verbal Appeal Request Form (DE-172) and send a copy to DMPSEligibilityHearings@azahcccs.gov. DES Staff: Complete and forward the Verbal Appeal Hearing Request (FA-100A) form as described in the CNAP manual at FAA6.F03A Appeal Hearings - Request Requirements

Follow the steps below when a customer requests that another person represent him or her at a hearing.

NOTE This procedure is not required if the customer’s Authorized Representative or legal guardian will represent the customer.

Step	Action
1	Send the customer a copy of the Authorization to Represent at Hearing (DE-169) form. Let the customer know that the DE-169 must be completed and returned for the person to represent them at the hearing. NOTE DES staff only: Accept a signed written statement rather than a form.
2	Did the customer return the completed DE-169 or signed written statement? If YES, continue to step 3. If NO, STOP. No further action is required
3	Did you receive the completed DE-169 or written statement before the hearing packet was completed? If YES, include the form or statement in the hearing packet. Notify your Agency’s appeals office that the customer has requested that someone else represent them at the hearing. AHCCCS: Email DMPSEligibilityHearings@azahcccs.gov. Attach a copy of the DE-169 to the email. DES: Email OIG.PA.Appeals@azdes.gov. Attach a copy of the signed written statement. If NO, continue to step 4.
4	Is the customer appealing an ALTCS decision? If YES, add the form to the hearing packet in DocuWare. Notify the AHCCCS Appeals unit by email at DMPSEligibilityHearings@azahcccs.gov. Attach a copy of the DE-169 to the email. If NO, scan the form into HEAplus and add the form to the hearing packet in DocuWare.