(928) 779-2113
Frequently Asked Questions
- Is Capstone an AHCCCS Plan?
- How do I become a participating provider with Capstone Health Plan?
- How do I get an AHCCCS Provider Registration Number?
- How do I appeal a denial by Capstone of a requested service?
- What well services / screenings are covered for adults?
Is Capstone an AHCCCS Plan?
Capstone subcontracts with the Department of Economic Security's Division of Developmental Disabilities (DES/DDD) to manage the health care services for Arizona Long Term Care Members. Although you wonÕt find Capstone Health Plan listed on the AHCCCS website, Capstone is a Medicaid plan and adheres to all AHCCCS rules and regulations.
How do I become a participating provider with Capstone Health Plan?
Contact the Provider Relations department to find out how to join our Provider Network. You must have a current AHCCCS Provider Registration Number to be reimbursed for providing services to Capstone members.
How do I get an AHCCCS Provider Registration Number?
Contact the Provider Registration department at AHCCCS to learn how to become a registered provider in Arizona at (602) 417-7670 or visit their website at http://www.azahcccs.gov
How do I appeal a denial by Capstone of a requested service?
Providers cannot appeal a denial of a service by the CapstoneÕs Medical Director. Only a member or his/ her representative can appeal. The member may also delegate in writing their appeal right to the provider, by using this Authorization for Disclosure Form.
What well services / screenings are covered for adults?
As of October 1, 2010, AHCCCS no longer covers annual well visits for adults over age 21. However, Pap smears; mammograms; screenings (hypertension, cholesterol, colon cancer, STD/HIV, TB, and prostate) and physical exams done in conjunction with an ICD-9 code indicating a disease or symptom are still covered.
