Key takeaways
- Every AHCCCS member can get medically necessary behavioral health services, and no referral is needed to start.
- The provider must be contracted with your health plan. Your plan's member services number, on the back of your ID card, can find one for you.
- AHCCCS sets deadlines: an initial behavioral health assessment within 7 days of your request, and a psychiatric medication appointment within 30 days.
- If your plan cannot get you seen in time, call member services first, then the AHCCCS Clinical Resolution Unit at 602-364-4558 or 1-800-867-5308.
- Video visits count. If your provider offers telehealth, you can be seen from anywhere in Arizona.
To find an AHCCCS behavioral health provider, start with your health plan, not a general search. Every AHCCCS member is eligible for medically necessary behavioral health services, including assessments and psychiatric medications, and no referral is needed to start (AHCCCS (opens in a new tab)). Call the member services number on the back of your ID card, or contact a provider directly and confirm they are contracted with your plan. If you cannot get an appointment in time, AHCCCS sets deadlines your plan has to meet.
Who counts as an AHCCCS behavioral health provider?
Behavioral health covers a wide range of care. AHCCCS lists screenings, case management, medications, crisis services, counseling, substance use treatment, peer support and family support among the services members can get (AHCCCS (opens in a new tab)). Different providers do different parts of that:
- Psychiatric prescribers: psychiatrists (physicians) and psychiatric-mental health nurse practitioners (PMHNPs) evaluate, diagnose and prescribe. If you need a diagnosis or help with psychiatric medication, this is who you are looking for. The roles are compared in psychiatric nurse practitioner vs. psychiatrist.
- Therapists and counselors: talk therapy, often alongside a prescriber.
- Behavioral health clinics: some members are assigned a clinic that coordinates their care. If you have one, it is the first call.
- Crisis services: available to all adults and children in Arizona regardless of insurance (AHCCCS (opens in a new tab)).
How do I find a provider that takes my AHCCCS plan?
Step 1: Find your plan's name
It is printed on your AHCCCS ID card. AHCCCS Complete Care plans differ by county, so two neighbors can have different plans.
Step 2: Call member services
The number is on the back of your card. Ask for an in-network behavioral health or psychiatric provider who is taking new patients, and whether video visits are available.
Step 3: Or contact a provider directly
AHCCCS allows you to reach out to a provider yourself. The provider must be contracted with your health plan, so ask: "Are you in network with my AHCCCS plan, and are you taking new patients?"
Step 4: Tell your primary care provider
AHCCCS asks members to let their primary care provider, or assigned behavioral health clinic, know about every provider they see, so care is coordinated.
AHCCCS publishes the member services number and website for each health plan (AHCCCS (opens in a new tab)), and its health plan list shows which plans serve which counties (AHCCCS (opens in a new tab)). If you are not sure which plan you are in, AHCCCS Beneficiary Support can help at (602) 417-7100 or 1-800-334-5283.
How long should I have to wait? The AHCCCS deadlines
AHCCCS requires health plans to get members seen within set timeframes. For behavioral health, its member notice lists (AHCCCS (opens in a new tab)):
- Urgent need: no later than 24 hours from identification of need.
- Initial assessment: within 7 calendar days of your referral or request.
- First service after the assessment: adults, no later than 23 calendar days after the assessment; under 18, no later than 21 days.
- Psychiatric medications: urgency assessed immediately, and an appointment no later than 30 calendar days from your request.
- Later services: no later than 45 calendar days from identification of need.
If you cannot get an appointment within those timeframes, call your health plan's member services first. If the problem is not resolved, AHCCCS lists its Clinical Resolution Unit at 602-364-4558 or 1-800-867-5308 (AHCCCS (opens in a new tab)).
Why is it hard to find a psychiatric provider who takes AHCCCS?
It is not just you. A national study of office-based physicians found that in 2009–2010 about 43% of psychiatrists accepted new Medicaid patients, compared with about 73% of physicians in other specialties (Bishop et al., JAMA Psychiatry, 2014 (opens in a new tab)). AHCCCS is Arizona's Medicaid program, so the same pattern shows up when members look for a psychiatric prescriber.
Two things widen your options. Psychiatric nurse practitioners are prescribers too, and in Arizona they evaluate, diagnose and prescribe; see what a psychiatric nurse practitioner does. And telehealth removes distance: a video visit counts the same as an office visit when your provider offers it, as long as you are in Arizona during the visit. More in telehealth psychiatry in Arizona.
Is online psychiatry covered by AHCCCS?
AHCCCS-contracted providers may offer behavioral health visits by video. What matters is the same as for an office visit: the provider must be contracted with your plan. Ask member services, or the provider, whether the visit can be by video and whether there is any cost to you.
AHCCCS psychiatric care at Better Place Now
Better Place Now accepts AHCCCS through Banner-University Family Care and the American Indian Health Program, at $0 cost to members: no copays and no missed-appointment fees. Care is psychiatric evaluation and medication management with Dr. Justin Schwarting, DNP, PMHNP-BC, a board-certified psychiatric nurse practitioner, for children 6 and up, teens and adults. Visits are by secure video anywhere in Arizona, or in person in the Phoenix area by arrangement, and the first visit is a full 60 minutes. Same-week openings are available.
- Banner-University Family Care is offered in Maricopa, Pinal, Pima, Cochise, Santa Cruz, Yuma, La Paz, Gila, Graham and Greenlee counties. See care in Phoenix and the Valley or care in Tucson.
- In Apache, Coconino, Mohave, Navajo and Yavapai counties, the American Indian Health Program is the AHCCCS route for eligible members; see care in Flagstaff and Northern Arizona.
- On a different AHCCCS plan, such as Mercy Care, Arizona Complete Health or UnitedHealthcare Community Plan? Those are not on the practice's list. Send a note with your plan name and the team will tell you before anything is scheduled.
Details are on the AHCCCS page. To start, request an appointment: call, text or email with your plan name. No referral and no health details are needed to schedule.
Common questions
Do I need a referral to see a behavioral health provider with AHCCCS?
No. AHCCCS states that referrals are not required to start behavioral health services. You can call your plan's member services or contact a provider directly, as long as the provider is contracted with your plan.
How long does AHCCCS give my plan to get me a psychiatric medication appointment?
AHCCCS's appointment standards say urgency is assessed immediately and the appointment must be no later than 30 calendar days from your request. An initial behavioral health assessment must happen within 7 calendar days of your request.
What do I do if I can't find an AHCCCS provider with openings?
Call your health plan's member services and say you cannot get an appointment within the AHCCCS timeframes. If that does not resolve it, AHCCCS lists its Clinical Resolution Unit at 602-364-4558 or 1-800-867-5308.
Does Better Place Now take AHCCCS?
Yes, through Banner-University Family Care and the American Indian Health Program, at $0 cost to members, by secure video anywhere in Arizona or in person in the Phoenix area by arrangement. Other AHCCCS plans are not on the practice's list; the team will check before anything is scheduled.
Sources
- How to access behavioral health services (opens in a new tab). Arizona Health Care Cost Containment System.
- Standards: appointment availability for all AHCCCS members (ACOM 417) (opens in a new tab). Arizona Health Care Cost Containment System.
- Available health plans (opens in a new tab). Arizona Health Care Cost Containment System.
- Available Health Plans (AHCCCS Complete Care), by county (opens in a new tab). Arizona Health Care Cost Containment System.
- American Indian Health Program (AIHP) (opens in a new tab). Arizona Health Care Cost Containment System.
- Acceptance of insurance by psychiatrists and the implications for access to mental health care (opens in a new tab). JAMA Psychiatry (Bishop, Press, Keyhani, Pincus), 2014.
