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ALTCS Program Contractor Choices
What happens after ALTCS approval?
After ALTCS approves non-financial, financial, and medical eligibility, the eligibility specialist approves the case in the computer system.Within one day of the computer approval, the customer is assigned an AHCCCS ID number for the purpose of billing and tracking.Within three days of the computer approval, the customer is enrolled with their chosen program contractor.It typically takes another two weeks for the AHCCCS ID card to arrive. The program contractor then assigns the customer a case manager.The case manager sets an appointment to meet with the customer and his/her family to set up the ALTCS service plan and to allow the customer to select a hospital and a primary care physician.The case manager also explains the payment for services, provides a new member handbook, and answers questions for the new enrollee.
When the customer also has a Medicare-HMO, the customer is required to use these benefits before ALTCS will pick up the unpaid portions of the bills.This includes using the HMO's doctors, hospitals, and pharmacy services.
When the customer also has a Medicare supplement policy, the customer has the option of using their current doctors, hospitals, and providers, OR using the ALTCS program contractor services.If the customer chooses to use their own doctors and hospitals (and not the AHCCCS providers), the customer will have to pay the portion of the bills not covered by Medicare and their supplement, including any acute medical services prescribed by those doctors.If the customer chooses to use services through their ALTCS program contractor, AHCCCS/ALTCS uses the benefits of Medicare and their supplemental policy first, and then picks up the unpaid portions of the bills.
AHCCCS is always the payer of last resort.
The Current* Program Contractor Choices in Maricopa County include: (please note that these are not in order of priority nor is the order to imply a recommendation by this firm)
For a list of other Arizona Program Contractors Click Here
Please note that we cannot specifically tell you which provider to choose nor can we choose for you.We suggest that you research answers to these questions before making a final decision:
Who does the nursing facility/care home/assisted living center/home-based provider contract with?
What is the facility's AHCCCS Provider ID number?
How long must you private pay before you can roll onto ALTCS?
Does the current doctor contract with any of the providers?
Which hospital do you prefer?Is it contracted with any of the providers?
ALTCS Planning.net is not affiliated with AHCCCS / ALTCS / VA.
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**IMPORTANT NOTICE**
Our CLDP, Carol Aragon-Montgomery, prepares legal documents.OUR CLDP IS NOT AN ATTORNEY AT LAW AND IS NOT EMPLOYED BY ATTORNEYS AT LAW AND CANNOT GIVE LEGAL ADVICE.Your communications with our CLDP are kept CONFIDENTIAL by our CLDP, but since our CLDP is not an attorney at law, such communications are NOT PRIVILEGED (i.e., immune from Subpoena). Our CLDP can give you general factual information pertaining to legal rights, procedures, or options available to you in a legal matter when you are not represented by an attorney.Our CLDP cannot give you specific legal advice, opinions, or recommendations about your legal rights, remedies, defenses, options, or strategies. Please note that the Long Term Care Planning Services are of a financial planning nature and are not specific "legal" advice. Prices subject to change without notice.