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This document outlines the guidelines and criteria by which Arizona defines Disproportionate Share Hospitals (DSH) and describes the methodology for calculating and distributing DSH payments. It includes
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How to fill out ahcccs disproportionate share hospital

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How to fill out AHCCCS DISPROPORTIONATE SHARE HOSPITAL PROGRAM

01
Obtain the AHCCCS DSH application form from the Arizona Department of Health Services website.
02
Review the eligibility criteria for the Disproportionate Share Hospital Program.
03
Gather necessary financial documents and patient demographic information.
04
Fill out the application form completely, ensuring all sections are addressed.
05
Provide accurate data regarding hospital services provided to low-income patients.
06
Include detailed information about revenue sources and cost structures.
07
Review the completed application for accuracy before submission.
08
Submit the application by the specified deadline along with any required supporting documentation.
09
Keep copies of all submitted materials for your records.
10
Follow up with AHCCCS for any updates or additional information requests.

Who needs AHCCCS DISPROPORTIONATE SHARE HOSPITAL PROGRAM?

01
Hospitals that provide a high percentage of care to low-income individuals.
02
Institutions that serve a large number of uninsured patients.
03
Facilities seeking financial assistance to help cover costs associated with treating low-income populations.
04
Hospitals aiming to receive additional funding to improve services for their community.
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People Also Ask about

Federal law requires that state Medicaid programs make Disproportionate Share Hospital (DSH) payments to qualifying hospitals that serve a large number of Medicaid and uninsured individuals.
Founded in 1982, the Arizona Health Care Cost Containment System (written as AHCCCS and pronounced 'access') is Arizona's Medicaid program, a federal health care program jointly funded by the federal and state governments for individuals and families who qualify based on income level.
Founded in 1982, the Arizona Health Care Cost Containment System (written as AHCCCS and pronounced 'access') is Arizona's Medicaid program, a federal health care program jointly funded by the federal and state governments for individuals and families who qualify based on income level.
Income information is first collected from the Federal and State Data Services Hubs, if available, and compared to the income reported by the customer. When the customer reports income that is over the income limits for AHCCCS Medical Assistance (MA), it is reasonably compatible. No further proof is needed.
AHCCCS is Arizona's State Medicaid Program. AHCCCS Members who also have Medicare are called Dual Eligible Members. Being enrolled in the same health plan for Medicare and Medicaid is called “alignment.” Alignment provides: • One plan that coordinates all care.
What if I have private insurance? Can I still get AHCCCS? YES, if you have private insurance, AHCCCS will become secondary insurance. It will help cover costs that your private insurance won't cover.
In addition to federal funding, AHCCCS receives funds from the State of Arizona, allocated through the Arizo- na Joint Legislative Budget Committee (JLBC).

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The AHCCCS Disproportionate Share Hospital Program provides additional funding to hospitals that serve a significant number of low-income patients, helping to cover the costs of uncompensated care.
Hospitals that qualify as Disproportionate Share Hospitals (DSHs) are required to file with the AHCCCS for funding under this program. These hospitals typically serve a higher percentage of Medicaid patients and uninsured individuals.
To fill out the AHCCCS Disproportionate Share Hospital Program application, hospitals should follow the guidelines provided by AHCCCS, including gathering necessary financial and patient data, completing required forms, and submitting them by the deadline.
The purpose of the AHCCCS Disproportionate Share Hospital Program is to provide financial support to hospitals that serve a larger share of Medicaid and uninsured patients, thereby ensuring they can continue to operate and provide essential services.
Hospitals must report various pieces of information, including patient demographics, service utilization data, costs of care, and information about the number of Medicaid and uninsured patients served to qualify for funding.
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