Prompt responses to records requests can prevent claim denials
Records requested as part of a claim review must be returned within the time frame specified in the request. Failure to do so results in a claim denial. Starting November 1, 2025, most commercial claims denied for this reason will no longer be reprocessed if records are received later than one year after the denial date.
Applied behavior analysis (ABA) therapy codes that require prior authorization are no longer eligible for the Gold Card Program. You must use the standard prior authorization request process for these services.
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Starting November 1, 2025, the EviCore portal process will be updated to require records (reviewed only if/when audited).
Other news
Offsets for interest overpayments
We have discovered a claim payment system error resulting in interest overpayments. We have addressed the issue and will soon begin reconciling the overpayments through the usual process.
Check out this overview of our 2026 Medicare Advantage plans. No changes in networks, plan names, or plan administrators, but the 2026 member ID card will include information for both medical and dental benefits.
You can validate eligibility without an ID card
Did you know you can check eligibility without an ID card? It’s easy on the Availity portal—just search with the patient’s member ID and date of birth, and you’ll get the current status with all the details. You can also download AZ Blue member ID cards and save a copy to your patient file.
Free CEUs
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Arizona Community Grand Rounds: This collaborative platform brings together healthcare and community leaders to share insights and solutions related to current health issues. The monthly sessions (with CME option) have resumed after the summer pause. Access the October presentation on homelessness and human services in Arizona.
Blue Cross, Blue Shield, the Cross and Shield Symbols, Federal Employee Program, and FEP are registered service marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
AlloMend is a registered trademark of AlloSource.
Availity is a separate, independent company contracted with AZ Blue for provider portal services. Availity and Availity Essentials are registered trademarks of Availity, LLC.
Mountain Echo Academy is a Project Echo® replicate. Project Echo is a registered trademark of UNM Rainforest Innovations.
American Diabetes Association is a trademark of American Diabetes Association, Inc.
