“Change a NO from AHCCCS to a YES”

DDNN Fall 2015
Arizona Center for Disability Law

checked box for "yes" and not checked for "no"Every year, many people with disabilities call ACDL and tell us that they or someone in their family asked for a service from AHCCCS (Arizona Health Care Cost Containment System, Arizona’s Medicaid Agency), but were told no.  Here is a really important tip that might be able to help if this happens to you:

When you request a service through AHCCCS, you have to show that the service is medically necessary. 

If you don’t, AHCCCS may say no to your request.  This can be confusing because you may have already given AHCCCS a note from your doctor.  But what the doctor wrote doesn’t always say enough to get the service approved.  If you are denied, a good first step is to check your letter of medical necessity and see if it can be made better.  Doctors need to be sure to write that the service is “medically necessary” and it is also helpful for them to give more information about the person and why they need it. 

ACDL has more information on how to write a good letter and it can be found here: http://azdisabilitylaw.org/pdfs/How%20to%20Write%20Effecitve%20Ltr%20of%20Medical%20Necessity.pdf

For more information about AHCCCS, visit http://www.azahcccs.gov/Default.aspx