P521 Verifying a Setting is Licensed or Registered with AHCCCS

MA521A

Research the facility name and address in the Arizona Department of Health Services (ADHS) website.

Did you find a different name or spelling for the facility?

• If YES, search for the revised facility name in HEAplus. If a match is found, STOP. If no match is found, continue to step 3.

• If NO, continue to step 3.

Log in to PMMIS. Enter PR005 in the NTR field to go to the Provider Search screen.

Enter the facility name and press Enter. Did PMMIS find a match for the facility name entered?

• If YES, place an “S” in the field to the left of the name and press Enter to go to the Provider Addresses (PR015) screen for that facility. Continue to step 5.

• If NO, skip to step 6.

Search each match for one with an Active status. Is there a matching address for your facility with a status of Active?

• If YES, search again in HEAplus using the name from PMMIS, and if still no match then by the Provider ID. If a match is still not found, check with your supervisor to determine whether a ticket or a PCR should be created.

• If NO, continue to step 6.

Enter PR086 in the NTR field to go to the FFS Provider List screen.

Enter the facility’s ZIP code in the ZIP field.

NOTE     When searching more than one ZIP code, clear the county code for each entry. The search will not return records when the county code does not match with the ZIP code.

Enter the facility’s Provider Type and press Enter (see section 2 below for a list and description of provider types).

NOTE     When there is more than one provider type listed, you may need to search each.

Did PMMIS find a match for the facility?

• If YES, enter an “S” in the field to the left of the facility name to select the facility and press Enter. If the facility is active it will display the word “Active” under the facility type. Continue to step 10.

• If NO, skip to step 11.

Is there a facility with an Active status listed with your customer’s address?

• If YES, search again in HEAplus using the name from PMMIS, and if still no match then search by the Provider ID. If a match is still not found, check with your supervisor to determine whether a ticket or a PCR should be created.

• If NO, continue to step 11.

Does the facility claim to be a provider for the Division of Developmental Disabilities or subcontracted through another provider for AHCCCS?

• If YES, submit a PCR to get the information needed for the HEAplus entry.

• If NO, the facility is not a certified AHCCCS provider. Continue processing the case.

02, 71

39

50

36, 49

B5

B8

A5

39

35

39, 25

22

B6, 71

22, 35, 78

02

78, B1, B2, B3

A6