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Remittance Advice

Remittance Advice information illustrating how claims were paid, pended, denied or voided are available electronically or on paper. Both the electronic and paper remittance advices are generated weekly after each check run cycle.

ASC X12N 835 submitters

Providers that submit X12/837I or 837P will receive an 835 payment advice file in accordance with National Electronic Data Interchange Transaction Sets.

Transaction name: ASC X12N 835 (004010X091A)
Description: Claim Payment and Remittance Advice

  • If the providers submit claims/encounters through a Clearinghouse, the Clearinghouse will supply the provider with their remittance advice through their data exchange process. The Clearinghouse upon registration with Arizona Complete Health will be supplied the secured location to obtain the ASC X12N 835. Options for retrieval are;
    • Arizona Complete Health’s Provider Portal
      • Payment History link (Direct key)
      • Batch link (X12 submitters)
    • PaySpan
      • Providers that have an account with PaySpan can retrieve their remittance responses from PaySpan secured web portal at payspanhealth.com

Web Portal Submitters

Providers that have access to Arizona Complete Health's Provider Portal, that use the Direct Key option under the Create Claim link can retrieve their remittance advice under the Payment History link.

Paper Remittance Advice

Paper Remittance Advice are generated weekly and mailed to the billing provider. If the billing provider has submitted claims for multiple service providers, the Remittance Advice will contain a section for each. If a provider has not received their RA or need a historical copy, contact AzCH-CCP Provider Services at 1-866-796-0542

Appeal Information

Important Information

NPI is Now Required for All Providers. 

Providers should contact AzCH-CCP Provider Services at 1-866-796-0542 to address questions related to this Explanation of Payment. Providers are also encouraged to contact their assigned Provider Engagement Specialist.

If an initial claim requires correction, a corrected claim must be submitted within twelve months after the date of service or date of eligibility posting, whichever is later. When submitting a corrected claim, providers must reference the original claim number and utilize the correct bill type (when required). Failure to reference the original claim number or to utilize the correct bill type may result in the claim being denied as a duplicate or for being untimely. When submitting by paper, corrected claims must be mailed to:

Arizona Complete Health-Complete Care Plan
P.O. Box 9010
Farmington, MO 63640-9010

Providers that are dissatisfied with Arizona Complete Health-Complete Care Plan’s processing of its claim(s) have the right to file a Provider Claim Dispute. Provider Claim Disputes must be filed in writing no later than twelve months after the date(s) of service, date of eligibility posting, or within 60 days after the processing of a timely claim submission, whichever is later.  Providers must include all pertinent information when submitting a Provider Claim Dispute, including claim number(s), date(s) of service, and medical records, when appropriate, and must include a statement of the factual or legal basis that forms the basis for the Provider Claim Dispute. Provider Claim Disputes should be mailed to:

Arizona Complete Health-Complete Care Plan
Attn: Grievance and Appeals
1850 W. Rio Salado Parkway, Suite 211
Tempe, AZ 85281