Provider | Resources | Claims And Remits

Claims and Remits

In addition to claim status and online remit tools, we offer resources to help you understand requirements for claim submission, coding, and pricing.

Claim Adjustments-Provider Operating Guide Section 19 19 Claim Submission Provider Operating Guide Claim submission

Claim adjustment

You can submit claim adjustments electronically via the Availity Essentials Portal
Note: Go to “Claims & Payments > Claims > Claims & Encounters.” In the Claim Information section, under Frequency Type, select 7-Replacement of Prior Claim. Then enter the original claim number. Continue to complete the form to mimic the original claim with the exception of the information being corrected.
Claim Adjustments – Excerpt from AZ Blue Provider Operating Guide
Electronic Claim Adjustments Guide

Correcting a provider NPI

If you are correcting a provider NPI, please use our corrected claim form and include medical record documentation verifying the rendering provider.

TYPE OF PLAN	HOW TO ACCESS
AZ Blue Plans FEP Plans BlueCard (Out-of-Area) Plans	Availity Essentials Portal
ACA StandardHealth with Health Choice Plan (prefix IAZ)	Health Choice Provider Portal
Medicare Advantage Plans (prefix M2K)	For plans administered by AZ Blue: Availity Essentials Portal Other plan administrators: Arizona Priority Care (AZPC) Optum Health Network Arizona (OHNAZ)
Corporate Health Services (CHS) Group Plans (no prefix)	Contact the third-party administrator (TPA) named on the member ID card or use our search tool to find the TPA contact information: CHS Group - TPA Information Finder
BlueDental^SM Stand-Alone Plans (prefix 99D)	BlueDental Provider Portal

Access this content via the Availity Essentials portal (AZ Blue Payer Space).

TYPE OF PLAN	HOW TO ACCESS
AZ Blue Plans Federal Employee Program^® (FEP^®) Plans BlueCard^® (Out-of-Area) Plans Medicare Advantage Plans	Availity Essentials™ Portal
ACA StandardHealth with Health Choice Plan (prefix IAZ)	Health Choice Provider Portal
Corporate Health Services (CHS) Group Plans (no prefix)	Contact the third-party administrator (TPA) named on the member ID card or use our search tool to find the TPA contact information: CHS Group - TPA Information Finder
BlueDental Stand-Alone Plans (prefix 99D)	BlueDental^SM Provider Portal

Access this content via the Availity Essentials portal (AZ Blue Payer Space).

Outpatient Coding Guide (select edition below)

Access this content via the Availity Essentials portal (AZ Blue Payer Space).

All content below may be accessed only by contracted providers via the Availity Essentials portal (AZ Blue Payer Space).

Claim Pricing (AZ Blue Provider Operating Guide Section 20)

FEES	OUTPATIENT GLOBAL PRICING	OTHER PROPRIETARY PRICING GUIDELINES
Fee Schedule Tool Fee Updates-ASC Fee Updates-Outpatient Fee Updates-Professional Fee Updates-Unclassified Drug	Outpatient Global Pricing Guidelines Global Surgical Code Lists Minor Procedure Code Lists Revenue Code 0274 or 0278-CPT or HCPCS Lists	DME Months to Purchase List Included Services Guidelines and List Inpatient Unbundling Guidelines Modifier Pricing Actions Single Units of Service CPT and HCPCS Lists Single Units of Service Revenue Code Table

ANESTHESIA	MODIFIERS	OTHER STANDARD PRICING GUIDELINES
Anesthesia Base Units Lists (PDF) Anesthesia Pricing Guidelines (PDF) Maternity Epidural Anesthesia Pricing Guidelines (PDF)	Assistant Surgeon List 2026 October – Current Previous versions: 2026 July 2026 June 2026 April 2026 January 2025 July (PDF) 2025 January (PDF) 2024 September (PDF) 2024 April (PDF) 2024 January (PDF) 2023 July Revised (PDF) 2023 January Revised (PDF) Modifier 22 – Increased Procedural Services Guidelines (PDF) Modifier 26 TC Lists (Excel) Modifier 50 Table 2026 July-Current (PDF) Previous versions: 2026 January (PDF) 2025 July (PDF) 2025 January (PDF) 2024 April (PDF) 2024 January (PDF) 2023 July Revised (PDF) 2023 January Revised (PDF) Modifier 62 or 66 Pricing Guidelines (PDF) Modifier 63 Pricing Guidelines (PDF)	Consultation Pricing Guidelines (PDF) Drug Urine Screening Test Pricing Guidelines (PDF) Emergency Department Leveling Policy (PDF) Mammography Pricing Guidelines (PDF) Obsolete Pharmacy CPT/HCPCS Code Lists June 2026 - Current (PDF) Previous versions: September 2025(PDF) 2024 September (PDF) 2024 July (PDF) 2023 August (PDF) Same Day Readmission Pricing Guidelines (PDF) TENS Supply Pricing Guidelines (PDF)

HIPAA Transaction Standard: AZ Blue Companion Guide
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