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Incident, Accident, and Death & Seclusion and/or Restraint Reporting Reminders

Date: 08/16/24

Incident, Accident, and Death & Seclusion and/or Restraint

Reporting Reminder

As a reminder, in accordance with the Arizona Health Care Cost Containment System (AHCCCS) Medical Policy Manual (AMPM) Chapter 961, all providers must report the occurrence of any reportable event involving an AHCCCS member.  Providers must:

  • Ensure that they have created an account within the AHCCCS QM Portal.
  •  Report the occurrence of the incident through the submission of an Incident, Accident, and Death (IAD) report into the AHCCCS Quality Management (QM) Portal.
  •  Submit an IAD report within 2 business days from the date of the occurrence or notification of the occurrence of a reportable event.
  •  Submit an IAD report within 1 business day of the date of the occurrence or notification of the occurrence of a sentinel event.

For a full list of reportable events, please refer to AMPM 961 which can be found by accessing the link below.

Additionally, in accordance with AMPM Chapter 962, all providers must report the use of any seclusion and/or restraint (SAR) involving an AHCCCS member.  Providers must:

  • Report the use of a SAR to the plan within 5 business days of the incident.
  •  Complete the AHCCCS SAR Reporting Form (access the form in the link provided below).
  • Submit the completed form, along with the physician’s orders, to us at azchqualitymanagement@azcompletehealth.com within 5 business days of the incident.

Reference Links:

 

AzCH provider and staff:

If you have questions, please contact your AzCH PROVIDER Engagement Specialist. If you need your assigned Provider Engagement Specialist’s contact information, please email us at AzCHProviderEngagement@azcompletehealth.com.