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Title Last updated Attachments
Health Care Appeal Provider Certification Form for Expedited Medical Review 01/12/2015 (Tue)
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PDF icon APPEALS_PROVIDER_CERTIF.pdf13.46 KB
Health Care Appeal Request Form 01/12/2015 (Tue)
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PDF icon APPEAL_REQUEST_FORM.pdf12.28 KB
Health Care Appeals Packet 11/09/2020 (Wed)
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PDF icon Appeals_Packet Revised082520 (1).pdf221.65 KB
Health Care Appeals Transmittal Form 11/03/2015 (Wed)
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PDF icon p-1098_hcatransfrm March 18 2015.pdf272.68 KB
Health Care Services Organization (HCSO), Health, Medical, Dental, Optometric Service Corporations (HMDO), and Prepaid Dental Plan Organization (PDPO) Application Supplements 04/11/2020 (Mon)
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PDF icon Form EHCSOEXP: Health Care Services Organization UCAA Expansion Supplement154.11 KB
PDF icon Form EPDPOEXP: Prepaid Dental Plan Organization UCAA Expansion Supplement63.36 KB
PDF icon Form EHCSOPRI: Health Care Services Organization UCAA Primary Supplement60.26 KB
PDF icon Form EHMDOPRI: Health, Medical, Dental, Optometric Service Corporations UCAA Primary Supplement57.51 KB
PDF icon Form EPDPOPRI: Prepaid Dental Plan Organization UCAA Primary Supplement66.55 KB
Health Insurance Complaint 09/08/2018 (Tue)
Health Insurance Complaint | Denial 10/01/2018 (Thu)
Health Insurance Complaint | Denial 10/01/2018 (Thu)
Health Insurance Complaint | Employer-provided 03/02/2018 (Fri)
Health Insurance Complaint | Group Insurance Policy 10/01/2018 (Thu)
Health Insurance Complaint | Group Insurance Policy 10/01/2018 (Thu)
Health Insurance Complaint | Health Care Provider 07/04/2018 (Sun)
Health Insurance Complaint | Individual 10/01/2018 (Thu)
Health Insurance Complaint | Insurance Professional 02/11/2017 (Wed)
Health Insurance Complaint | Medicaid (AHCCCS) 10/01/2018 (Thu)
Health Insurance Complaint | Medicare 10/01/2018 (Thu)
Health Insurance Complaint | Medicare Advantage 10/01/2018 (Thu)
Health Insurance Complaint | Medicare Only 10/01/2018 (Thu)
Health Insurance Complaint | Medicare Supplement 10/01/2018 (Thu)
Health Insurance Complaint | Self-insured Plan 10/01/2018 (Thu)
Health Insurance Marketplace for Military Veterans 09/06/2015 (Mon)
Health Insurance Telemarketers Annoy; Pose Fraud Risks 04/01/2020 (Thu)
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PDF icon PressRelease_HealthInsuranceTelemarketers20181210.pdf223.06 KB
Health Insurance | Individual - Denial 10/01/2018 (Thu)
Health-e-Arizona PLUS 01/06/2015 (Sun)
Help for Businesses 10/12/2014 (Sat)
Help for Health Care Providers 04/09/2017 (Wed)
Help for Military Service Members 08/06/2015 (Sun)
Help for State Employees 01/12/2014 (Wed)
Help for State Employees 03/01/2019 (Mon)
Help With Auto Insurance 10/06/2020 (Mon)
Help with Health Insurance 10/05/2020 (Wed)
Help with Home/Title/Flood Insurance 06/06/2020 (Wed)
Help with Life Insurance and Annuities 03/12/2016 (Mon)
Helpful Hints 12/08/2014 (Mon)
HIPAA Report Exhibit 1: Products Offered in the Individual Marketplace 08/11/2014 (Fri)
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PDF icon HIPAA-l-2008.pdf10.19 KB
HIPAA Report Exhibit 2: Earned Premium Volumes and Covered Individuals 08/11/2014 (Fri)
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PDF icon HIPAA-l_l-2008.pdf10.33 KB