AHCCCS EDI FAQs (Frequently Asked Questions regarding EDI communication)

Following the series of posts for AHCCCS EDI partners, find below Part 2 Frequently Asked Questions regarding EDI communication.

Q: Our clearinghouse sent a request to be setup for 835, 270/271, 276/277. Why was the ticket closed without being setup?

A: A request for setup must come from an authorized individual from within the provider organization; it cannot be initiated by the provider’s clearinghouse/software vendor/billing service. Please have an authorized individual for the provider submit a request for setup with (name of clearinghouse) to EDICustomerSupport@azahcccs.gov. A ticket will be opened on the provider’s behalf and assigned to the ISD EDI Team to get the process started.

The authorized individual for the provider must be someone within the provider’s own organization that has the authority to accept the electronic TPA executed from the Community Manager (CM) web portal. Only the provider can accept the TPA (see Appendix 1) as it is a contractual agreement between the provider and AHCCCS.

Q: When can I start submitting transactions in production?

A: For 837, 270/271, 276/277 transactions, the trading partner will not be moved to production until they have successfully satisfied the AHCCCS required Community Manager testing phase and end-to-end testing phase.

Q: What is the payer ID for AZ MEDICAID/AHCCCS?

A: Payer ID’s are created by vendors/clearinghouses; it is how they enumerate payers within their system so that claims are routed to the appropriate payer. It is part of the claim submission process between the provider and the clearinghouse. AHCCCS would not have this type of information. The payer ID for AHCCCS could be enumerated differently by the many different clearinghouses we exchange electronic transactions with. You would need to reference the Payer ID list made available on the clearinghouse website to find the appropriate payer ID.

Q: How long are files kept in the SFTP/EFT EDI-OUT directory?

A: The files are kept for only 90 days.

Q: Why can’t I see the file I just uploaded in the EDI-IN directory?

A: Files are swept immediately out of the EDI-IN directory on the AHCCCS SFTP/EFT server, which can lead a trading partner to question whether the transmission was successful or not. The best thing to do is to check the EDI-OUT directory for an acknowledgement shortly afterwards. Should it be identified that no acknowledgements are received for a file transmission, which could indicate that there is a problem, you can email EDICustomerSupport@azahcccs.gov to inquire status of your file submission.

Q: Does AHCCCS accept NON-TEXT/EDI files, such as Zip, CSV, PDF, or MS Office (such as Word, Excel, etc.) in the EDI-IN folder?

A: AHCCCS does not accept NON-TEXT/EDI files uploaded to the EDI-IN folder. Non-Text/EDI files uploaded to the EDI-IN folder are immediately rejected/not processed. There will be no notification to Trading Partner for this error.

To learn more about EDI and become a certified EDI Professional please visit our course schedule page.

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