Provider News

PROVIDER MANUAL UPDATES - 12/30/2011
Sections of the Care1st Provider Manual have recently been updated (January 2012 revision date) and are available on our website.

5010 837 Helpful Hints - 12/29/2011
Effective 1/1/2012, trading partners are required to cease sending electronic transactions in the 4010 format and begin to send electronic transactions in the 5010 format.

MVD Photos Added To AHCCCS On-Line Eligibility Verification - 12/19/2011
Effective December 15, 2011, AHCCCS added member photos to its on-line verification tool that providers use to verify member eligibility.

Holiday Hours Notice - 12/08/2011
Care1st & ONECare 2011 Holiday Hours Notice (Includes Bridgeport information for Dental Practices)

PRIOR AUTHORIZATION UPDATE - 11/30/2011
The Care1st and ONECare Prior Authorization Guidelines has been updated. The new guideline is effective January 1, 2012.

BRIDGEPORT DENTAL SERVICES "NAME CHANGE" - 11/29/2011
Effective January 1, 2012, Bridgeport Dental Services will merge with its affiliate, Advantica Administrative Services, Inc. and will change its name to Advantica...

DEPENDABLE MEDICAL TRANSPORT SERVICES - 11/21/2011
Care1st and ONECare are partnering with Dependable Medical Transport (DMTS) to provide transportation services to Care1st and ONECare members...

CLAIMS PROCESSING FOR DATES OF SERVICE 10/1/11 AND AFTER - 10/21/2011
We communicated to you on October 3, 2011 that as a result of the request of Center for Medicare and Medicaid Services (CMS) for additional information from AHCCCS related to the October 1, 2011 5% provider rate reductions...

RSV UPDATE - 10/13/2011
As RSV season approaches, it is important to make arrangements to ensure that children who need Synagis® receive injections. Care1st will work with your office to authorize and obtain Synagis® with no out of pocket cost.

FORMULARY UPDATES - 10/06/2011
Formulary updates for Care1st (Acute and DDD) and ONECare have recently been approved by our Pharmacy and Therapeutics Committee and are effective October 30, 2011 for Care1st and October 15, 2011 for ONECare.

DELAY OF AHCCCS 5% Rate Reduction
The Center for Medicare and Medicaid Services (CMS) has requested additional information from AHCCCS related to the 10/1/11 5% provider rate reductions...

DENTAL AT A GLANCE GUIDELINES UPDATE (Effective 11/01/2012) - 09/30/2011
An Outline of changes to the Bridgeport/ Care1st Clinical Guidelines and "At a Glance Guidelines" effective November 1, 2011...

FLU VACCINE UPDATE - 09/20/2011
Care1st & ONECare are partnering with Mollen Flu Clinics to offer flu clinics for the 2011-2012 flu season...

Updated Prior Authorization Guidelines - 8/31/2011
The Care1st and ONECare Prior Authorization Guidelines has been updated and is available...

AHCCCS OCTOBER 1, 2011 BENEFIT & FEE SCHEDULE UPDATE - 08/30/2011
On March 15, 2011, Governor Brewer presented her plan to preserve Arizona's Medicaid program with reforms that will drive down costs....

AHCCCS Benefit Changes Effective October 1, 2011 - 08/08/2011
On March 15, 2011, Governor Brewer presented her plan to preserve Arizona's Medicaid program with reforms that will drive down costs by an estimated $500 million in the State's General Fund for the partial first year...

PROVIDER MANUAL UPDATES - 7/18/2011
The Care1st Provider Manual has recently been updated (July 2011 revision date) and is available.

PRIOR AUTHORIZATION UPDATE - 6/30/2011
The Care1st and ONECare Prior Authorization Guidelines has been updated.

NEW CLAIMS EDITING & FRAUD, WASTE & ABUSE PROGRAM IMPLEMENTATION - 6/29/2011
As part of our ongoing effort to improve performance in claims processing and payment, Care1st & ONECare are implementing a new claims editing program that will ensure a more thorough and comprehensive review of all claims by promoting compliance with globally accepted guidelines.

FORMULARY UPDATES - 5/26/2011
Formulary updates for AHCCCS (Acute and DDD) and ONECare have recently been approved by our Pharmacy and Therapeutics Committee and are effective July 1, 2011.

ELIMINATION OF PAPER REMITS FOR EFT PROVIDERS. - 5/26/2011
Currently we mail paper remittance advices and provide electronic remittance advices on our provider web portal that can be downloaded and/or printed.

FRAUD, WASTE AND ABUSE TRAINING FIRST TIER, DOWNSTREAM AND RELATED ENTITIES. - 5/25/2011
If you need any additional information or require assistance to complete training with your employees, please contact Provider Network Operations.

TELEPHONE SYSTEM UPGRADE - 5/24/2011
Due to a mandatory Qwest telephone upgrade, the Care1st phone system, including individual extensions, will be unavailable on Thursday, May 26, 2011 between 2 p.m. and 5 p.m.

TELEPHONE SYSTEM UPGRADE - 5/19/2011
Due to a mandatory Qwest telephone upgrade, the Care1st phone system, including individual extensions, will be unavailable on Thursday, May 26, 2011 between 2 p.m. and 5 p.m.

ELIMINATION OF PAPER REMITS FOR EFT PROVIDERS - 4/22/2011
During discussions with many of you who are receiving EFT, we learned of the preference to review and/or download remittance advices from the provider portal....

AHCCCS RESTORES COVERAGE OF TRANSPLANTS FOR ADULTS - 4/19/2011
As part of the recently enacted budget, the Arizona Legislature adopted Governor Brewer's Medicaid Reform Plan which restores funding of previously covered transplants for adults that were eliminated effective October 1, 2010...

CONTROLLED SUBSTANCE PRESCRIBING RECOMMENDATIONS- 4/18/2011
Based on discussions held during our Pharmacy and Therapeutics Committee Care1st and ONECare recommend that you...

BRIDGEPORT OFFICE CLOSURE FRIDAY, APRIL 22, 2011
Bridgeport's office will be closed for business on Friday, April 22, 2011 in observance of Good Friday. Bridgeport will reopen Monday, April 25th at 7:00 a.m.

ONECARE INTEGRATED CARE MANAGEMENT AND IN-HOME MEMBER EXERCISE PROGRAM AVAILABLE - 3/30/2011
ONECare is excited to announce the launch of our partnership with the Area Agency on Aging, Region One (AAA), which includes an Integrated Care Management Pilot Project, and an individually-tailored evidencebased fall prevention/in-home fitness program as a value-added benefit for our members.

ORTHOTICS & PROSTHETICS NETWORK UPDATE- 3/18/2011
Effective April 15, 2011, the Care1st & ONECare orthotics & prosthetics network will be comprised of the following contracted entity and all related sites...

DENTAL AT A GLANCE GUIDELINES UPDATE - 3/17/2011
Effective Immediately.

WEBSITE DOWN TIME - 3/11/2011
We are undergoing a system upgrade this weekend. As a result, Member Eligibility and Claim Look Up functions will not be available from Friday, March 11, 2011 at 5p.m. until 8a.m. Monday, March 14, 2011.

Updated Prior Authorization Guidelines (Effective March 15, 2011) - 3/9/2011
As a reminder, attached is the updated Care1st and ONECare Prior Authorization Guidelines. The updates noted below are effective March 15, 2011.

AHCCCS APRIL 1, 2011 FEE SCHEDULE UPDATE - 3/1/2011
The Health Budget Reconciliation Bill from the 2010 Legislative Session (HB2010) authorized AHCCCS to reduce both institutional and non institutional rates up to 5% for the rate year beginning October 1, 2010...

AHCCCS APRIL 1, 2011 FEE SCHEDULE UPDATE (DENTAL) - 3/1/2011
The Health Budget Reconciliation Bill from the 2010 Legislative Session (HB2010) authorized AHCCCS to reduce both institutional and non institutional rates up to 5% for the rate year beginning October 1, 2010...

DENTAL PROGRAM UPDATE - 2/25/2011
Bridgeport Dental Service "Address Change" for PA Requests (Effective April 1, 2011)

Updated Prior Authorization Guidelines - 2/15/2011
Effective March 15, 2011

Formulary Updates - 2/10/2011
Formulary updates for AHCCCS (Acute and DDD) and ONECare have recently been approved by our Pharmacy and Therapeutics Committee and are effective February 1, 2011.

BIRTHING CENTER CLOSURE - 2/9/2011
Effective February 5, 2011 the Birthing Center at John C. Lincoln North Mountain is closed.