Health Services

Care Coordination

HS-CC-01 Transition of Members

HS-CC-02 Care Management

HS-CC-03 Identifying Members with Special Health Care Needs

Maternal Child Health

HS-CH-01 AzEIP Referrals and Services

HS-CH-02 DCS CHP EPSDT Monitoring and Performance

HS-CH-03 EPSDT Services

HS-CH-04 HIV Testing and AIDS Treatment Services

HS-CH-05 Pregnancy Termination

HS-CH-06 Dental and Orthodontic Services

HS-CH-07 Maternity Postpartum and Family Planning Services

HS-CH-08 AHCCCS Reported EPSDT Performance Measures

Medical Management

HS-MM-01 End of Life Care and Advanced Care Planning

HS-MM-02 Medical Management Program

HS-MM-03 Transportation

HS-MM-04 Prior Authorization

HS-MM-05 Prescription Medication Services

HS-MM-06 Emergency Services

HS-MM-07 Request for New Technology, Experimental or Investigational Therapies, and Clinical Trials

HS-MM-08 Inter-Rater Reliability Testing

HS-MM-09 Notice of Adverse Benefit Determinations (NOA), Notice of Extension (NOE), and Notice of Provider Restriction

HS-MM-10 Concurrent Review, Retrospective Review, Readmissions and Discharge Planning

HS-MM-11 Transplant Services

Quality Management

HS-QM-01 Individual Provider and Group Credentialing

HS-QM-02 Clinical Practice Guidelines and Authorization Guidelines

HS-QM-03 Quality of Care

HS-QM-04 Medical Record Review

HS-QM-05 Peer Review

HS-QM-06 Proactive Care Coordination