Prior Authorization in Arizona
Soft Home Global provides authorizations submitted ahead of the date of service and chased to a decision for Arizona practices and billing companies at $1,900 per seat per month. Full time, worked during Arizona business hours, inside your own system.
What is specific to Arizona
Arizona delivers AHCCCS almost entirely through contracted health plans, with AHCCCS Complete Care covering acute and behavioral needs and separate programmes for long-term care, so claims usually go to a plan.
Arizona’s Medicaid programme is AHCCCS (Arizona Health Care Cost Containment System). Practices with a meaningful AHCCCS (Arizona Health Care Cost Containment System) mix usually need it worked as its own queue rather than mixed into commercial follow-up, because the submission path, the timely filing window and the appeal route are all different.
What a prior authorization seat does in Arizona
Submitted before the date of service and chased through the payer's decision window.
An authorisation found after the visit is a write-off, not a denial to appeal. In Arizona the work is submitting ahead of scheduling and chasing the decision, against a payment clock that starts only once a clean claim lands.
- Authorizations submitted ahead of scheduling, not after
- Status chased rather than waited on
- Peer-to-peer reviews scheduled when required
- Clinical documentation gathered before submission
- Expiring authorizations flagged before they lapse
- Worked during Arizona business hours, not queued overnight
For the statute behind all of this — Arizona’s prompt-pay deadline, its Medicaid filing limit, and the wrinkle that catches people out here — see the Arizona billing page.
Working Arizona hours
Arizona runs on Mountain time, 12 hours behind our floor in Rawalpindi. To be at a desk for your nine to five, the shift here runs 9pm to 5am. Arizona does not observe daylight saving, so that overlap is the same every week of the year. For most of the country it moves twice, and the practices that notice are the ones whose payer calls sit near the edge of the window.
One wrinkle worth naming: the Navajo Nation does observe daylight saving. If your practice sits on that side of the line, say so on the call and the shift is set to your clock rather than the one most of the state keeps.
That is the part that decides whether follow-up happens at all: a payer’s phone lines are open on Arizona hours and nobody else’s.
What it costs in Arizona
$1,900
Per seat, per month, in US dollars — $22,800 a year for one full-time person, forty hours a week, on Arizona hours. No annual contract, no percentage of collections, no setup fee and no software to buy. Seat prices across all roles in Arizona run $1,500 to $2,500; the full list is published.
That is the entire invoice. Run your own figures against a percentage vendor or a hire rather than take ours.
Getting started in Arizona
About a week from a signed agreement to a person working your queue, and that week of training on your workflow is not billed on top. The work happens in your own system under a login you issue, so there is nothing to migrate and nothing to install. The week, step by step, and what is signed before anyone has access.
Questions
Do you work with Arizona practices?
Yes. Arizona accounts are worked during Arizona office hours rather than queued overnight, because a payer's phone lines are open then and at no other time.
What is different about Arizona?
Arizona delivers AHCCCS almost entirely through contracted health plans, with AHCCCS Complete Care covering acute and behavioral needs and separate programmes for long-term care, so claims usually go to a plan.
How long do we have to file a AHCCCS (Arizona Health Care Cost Containment System) claim?
6 months from the date of service to submit; 12 months to be a clean claim, measured from the date of service (or the date eligibility is posted, if later, for the clean-claim limit). The claim must reach clean-claim status within twelve months of the date of service. Past that date a claim is not late, it is unpayable, and no appeal recovers it. Source: A.R.S. § 36-2904 — AHCCCS; claims.
When does a Arizona payer have to pay a clean claim?
30 days to adjudicate a clean claim, then a further 30 days after adjudication to pay the approved portion — so up to ~60 days end to end. No electronic-versus-paper distinction in the statute. A claim sitting past that is not merely late, it is late against a statute, and the follow-up call changes from "when might this be paid" to "this passed your statutory window on a specific date".
How much does prior authorization cost in Arizona?
$1,900 per seat per month — $22,800 a year for a full-time person, forty hours a week. Every seat price is published at softhomeglobal.com/pricing.
What hours will somebody actually be working our Arizona queue?
Arizona is on Mountain time, 12 hours behind Rawalpindi. The shift here runs 9pm to 5am so your seat is at a desk for your full working day. Because Arizona does not observe daylight saving, that window is identical every week of the year.
Do you handle AHCCCS (Arizona Health Care Cost Containment System) as well as commercial payers?
Yes, and as its own queue rather than mixed into commercial follow-up. AHCCCS (Arizona Health Care Cost Containment System) has its own submission path, its own filing window and its own appeal route, and working it in the same worklist as commercial claims is how the deadlines get missed.
Is this a percentage of what you collect?
No — a flat monthly rate per seat, published at softhomeglobal.com/pricing. A percentage bills you most in your best month and points the vendor at the easy accounts.
What is the minimum commitment, and how quickly can somebody start?
One seat for one month, cancellable on thirty days notice, and about a week from a signed agreement to a person working your queue. The week of training is not billed. The steps are at softhomeglobal.com/how-it-works.
Is our patient data safe offshore?
A Business Associate Agreement is signed before anyone has access, and the work happens in your own system under a login you issue, so every action is attributable to a person in your audit trail. The controls are listed at softhomeglobal.com/security.
Next step
One seat on your Arizona work
Twenty minutes on a call is enough to tell whether this fits. If it does not, I will say so.
Or write to ops@softhomeglobal.com