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Pre-Auth Check

Arizona Complete Health hears you. We’re continually focused on enhancing your experience. Use our secure provider portal to submit your Medicaid and Marketplace prior authorization (PA) requests. Your PA request will feed directly into our system and allow us to receive and respond faster. Go to https://www.azcompletehealth.com/ then “Login” to register or log in.

ProductIs Auth RequiredSubmit PA via PortalSubmit PA via AvailitySubmit PA via Fax
Arizona Complete Health-Complete Care Plan
(Medicaid)		Medicaid Pre-Auth Check ToolRequest via PortalRequest via Availity

Fill PDF and Fax:

Supplemental Form:

Wellcare by Allwell 
(Medicare)		Medicare Pre-Auth Check Tool Request via PortalRequest via Availity

Fill PDF and Fax:

Supplemental Form:

Ambetter from Arizona Complete Health
(Marketplace)		Marketplace Pre-Auth Check Tool Request via PortalRequest via Availity

Fill PDF and Fax:

*Details on NEW Ambetter PA Forms required per A.R.S. 20-3406 available here

Supplemental Form:

For Psychological/neuropsychological Testing
Please refer to this Psychological/neuropsychological testing prior auth provider assistance tool (PDF).

Please note, failure to obtain authorization may result in administrative claim denials. Arizona Complete Health providers are contractually prohibited from holding any member financially liable for any service administratively denied by Arizona Complete Health for the failure of the provider to obtain timely authorization.

For additional information visit our Prior Authorization page
Prior Authorizations