Electronic Visit Verification (EVV) Prior Authorization Connection with Sandata

Date: 05/13/25

This communication applies to provider types who are required to report on EVV.

AHCCCS contracts with EVV Vendor, Sandata, to perform the AHCCCS aggregator, i.e. repository, functions. Sandata’s system stores EVV prior authorization data and visit information for the purpose of verifying the visit information matches claim data prior to health plans finalizing associated claims for payment or denial.

Prior authorization data is required by Sandata before building the visit. All visit information must be finalized in Sandata’s repository before submitting the claim to allow the health plan to validate the claim and visit match before completing claim processing.

On March 27th, the prior authorization connection between Arizona Complete Health-Complete Care Plan/Care1st Health Plan and Sandata had to be disabled. A resolution was agreed upon and AHCCCS approval to proceed was received Friday May 9th. As a result, we’ve begun the necessary work with Sandata to successfully test and implement the new process. We expect implementation to take approximately two weeks. We’ll notify you as soon as we confirm the official go live date

In the meantime, it’s possible you may receive a claim denial(s) if we are unable to fully verify a visit due to the disabled prior authorization connection. Once the prior authorization linkage is reestablished, our intent is to identify and reprocess claims for which Sandata’s system reflects all visit information required to validate the claim, but the claim denied due to the disabled connection.

Resource: AHCCCS EVV web 

If you have questions, please contact your Provider Engagement Specialist. If you need your assigned Provider Engagement Specialist’s contact information, please email us.