Provider tools

Important info for providers

Checking Eligibility

To check a member's eligibility, please visit the AHCCCS Complete Care website. Here you'll be able to use your AHCCCS Online user ID and password to login and check if the member is eligible.

Notification of Pregnancy

Per AHCCCS policy, we ask that you notify us as promptly as possible when a Magellan Complete Care member has tested positively for pregnancy. We’ll partner with you to ensure the member is enrolled into a prenatal program as soon as possible to ensure the healthiest of pregnancies.

Please also let us know of missed prenatal appointments. Our care coordinators are here to help our Magellan Complete Care members stay on track with their preventative health. We want to help contact these members to solve issues around missed appointments.

To report a positive pregnancy test call our Customer Service Department at 1-800-424-5891. We’re here to take your call Monday through Friday from 8 a.m. until 6 p.m.

Notification of Missed Appointments

Please notify us of members who miss their scheduled appointment. Missed appointments should be reported via fax, weekly, to 888-656-7539 or by emailing the MCH/ESPDT Coordinator directly at MCCofAZMissedAppointments@magellanhealth.com. We’ll contact these members to educate them on the importance of keeping scheduled appointments and to discuss any barriers in attending the medical appointment.

Magellan Complete Care of Arizona reminds all providers of the importance of setting follow up appointments with members before they leave the office, and reminds them of upcoming appointments. This is a great way to decrease no shows. It is expected that providers will contact patients who miss appointments and educate them about the importance of preventive care appointments.

Cultural Competency

We strive to ensure our members receive the highest level of health care available to them. Many of our members come from various cultural and linguistic backgrounds. The cultural background of each person we work with influences how they hear us, how they speak to us, and how willing they are to trust us. Understanding and adapting to the cultural background of each person will help us build more effective relationships. The National Standards for Culturally and Linguistically Appropriate Services (CLAS) aim to promote health equity through providing clear strategies to guide us when working with members of various ethnic and linguistic differences. Learn more about the fifteen CLAS standards here.

EPSDT Services

EPSDT services provide comprehensive health care through primary prevention, early intervention, diagnosis, medically necessary treatment, and follow-up care of physical and behavioral health conditions for AHCCCS members under 21 years of age. EPSDT services include screening services, vision services, dental services, hearing services and all other medically necessary, mandatory, and optional services listed in Federal Law 42 USC 1396d (a) to correct or ameliorate defects and physical and behavioral/mental illnesses and conditions identified in an EPSDT screening, whether or not the services are covered under the AHCCCS State Plan.

AHCCCS EPSDT Tracking Forms 

Contact information for AHCCCS Contracted health care plans may be found at www.ahcccs.state.az.us.

The Arizona Health Care Cost Containment System (AHCCCS) EPSDT Tracking Forms must be used by all providers offering care to AHCCCS members less than 21 years of age to document age-specific, required information related to EPSDT screenings and visits. Only AHCCCS EPSDT Tracking Forms may be used; paper form substitutes are not acceptable. However, the provider may choose to utilize an electronic EPSDT Tracking Form generated through AHCCCS (once available) or the provider’s electronic health record system, so long as the electronic form includes all components present on the AHCCCS EPSDT Tracking Form. These components include, but are not limited to:

  • Documentation of comprehensive physical exam (including appropriate weights and vital signs)
  • Age-appropriate screenings (vision, hearing, oral health, nutrition, developmental, nutritional, tuberculosis (TB) and lead)
  • Developmental surveillance
  • Anticipatory guidance (Age Appropriate Education and Guidance)
  • Social-emotional health (behavioral health) surveillance
  • Age-appropriate labs and immunizations
  • Medically necessary referrals including those to the member’s dental home starting at 1 year of age, or sooner as needed, for routine biannual examinations.

 

You can print the EPSDT from our Provider Forms. You can also download and print a copy of the EPSDT form from the AHCCCS website. If you would like a 2 part carbonless copy of an EPSDT form mailed to you, please call to request at 800-424 -5891.

 

Completed EPSDT forms should be faxed back to 888-656-7539. Or you can mail to:

Magellan Complete Care of Arizona

Attention: EPSDT Coordinator 4801 E. Washington St.

Phoenix, AZ  85034

 

AzEIP (Arizona Department of Economic Security) referrals can be made 2 ways, you can either call 602-635-9799, or you can refer online at https://des.az.gov/services/disabilities/developmental-infant.

 

If you have any questions about EPSDT requirements, immunization requirements, dental or referrals when working with this program or AHCCCS, all guides and manuals can be found online at www.azahcccs.gov.

We provide no-cost help and services to people with disabilities. We want our members to be able to communicate with us easily. We offer:  

  • Qualified sign language interpreters 
  • Written information in many formats. These may include: 
    • Large print
    • Audio
    • Accessible electronic formats
    • Other formats

We also provide no-cost language services to people whose first language is not English. We offer: 

  • Qualified interpreters
  • Information that is written in other languages

Contact us at 1-800-424-5891 (TTY 711) if any MCC of AZ members need any of these services.