Members

Understanding Your Care

If you still do not understand, let your doctor, nurse or pharmacist know you need further explanation of what you need to do. Try not to be nervous to ask your health provider questions. Your medical team wants you to let them know that you need help. They want you to know how to prevent future illness or keep your condition in control.

When you prepare to see your healthcare provider, make sure you let your doctor, nurse, technician etc. know of any lifestyle changes such as a change in diet, exercise, medications etc. It is important that you communicate with them as well as they communicate with you.

Health Choice recognizes the diverse backgrounds and cultures of our members. The plan is dedicated to offering services that are sensitive to the needs of our members. Also, Health Choice representatives are trained to be culturally aware and sensitive to member’s needs.

For more information, call Member Services toll-free at 1-800-322-8670, Monday through Friday (except holidays), 6 a.m. – 6 p.m. TTY/TTD users can call 711. You may also contact us by e-mail at comments@healthchoiceaz.com.

Translation and Interpreter Services

If there is a doctor that is close to your home and speaks your language, we will assign that doctor as your primary care provider (PCP). You may always call to change your PCP if you would rather have another doctor that has an office in your area.

If you need translation or interpreter services, please call our Member Services Department at 1-800-322-8670 at least four (4) business days prior to your routine appointments to arrange translation services in time for your doctor or any other medical appointments.

You may also call us if you need any of our printed information in another language or a different format. There is no cost for translation services. Please call Member Services for instructions on obtaining culturally competent materials and/or services, including translated member materials.

If you are deaf and need the help of a signer call Member Services at 1-800-322-8670 and we will get one for you.

Health & Wellness Programs

Stork Program
Pregnant women can register for our Stork Program and receive information and guidance from our maternity nurses to help them have a healthy pregnancy.
Member Services toll-free at 1-800-828-7514.

Health Kids & Families
Taking your children to the doctor for well-child visits and shots is one of the most important things you can do to keep them from getting very sick.
Member Services toll-free at 1-800-322-8670.

Learn More

 

Adult Health Choice Arizona
Seeing your doctor for regular checkups and health screenings is one of the most important things you can do to stay healthy.
Member Services toll-free at 1-800-322-8670.

Learn More

AHCCCS: Arizona Health Care Cost Containment System
ALTCS: Arizona Long Term Care System
AzEIP: Arizona Early Intervention Program
CRS: Children Rehabilitative Services
DDD: Division of Developmental Disabilities
DES: Department of Economic Security
EPSDT: Early and Periodic Screening Diagnosis and Treatment
HIPPA: Health Insurance Portability and Accountability Act
NARBHA: Northern Arizona Regional Behavioral Health Authority
PCP: Primary Care Physician
PPC: Prior Period Coverage – member was or is in transitional period with regard to coverage while AHCCCS completes the enrollment process
QMB: Qualified Medicare Beneficiary
RBHA: Regional Behavioral Health Authority
SOBRA: Sixth Omnibus Budget Health Authority
WIC: Women, Infants and Children (nutritional program)


Appeal – A formal complaint made where a member is not satisfied with a decision made by Health Choice Arizona.
Behavioral Health Crisis – A situation where, without immediate help, you might hurt yourself or someone else.
Behavioral Health Services – Behavioral health services may include behavior management, group, family and individual therapy and counseling, and emergency/crisis services.
Co-payment – A small charge or fee due at the time covered services are provided.
Emergency – A situation where a person’s health, or the health of an unborn baby, could be threatened. Medical help is needed right away.
Grievance – A member’s expression of dissatisfaction with any part of their care. A grievance can be filed over the phone or in writing.
Health care Power of Attorney – Someone to whom you have given the authority to make health care decisions for you if you cannot make them (usually a close friend, relative or spouse).
High-risk pregnancy – A pregnancy for which the mother or baby may be at higher risk for illness or death.
Living Will – A document where you write what you want done with your health care. The doctor uses this if you are not able to express what you want. It lists specific treatments you do or do not want. It can also tell your doctor whether or not to make special efforts to save your life.
Mammogram – Screening exam for breast cancer. Recommended for women over the age of 35.
Managed Care – A health plan that works like an HMO. Covered services are provided by providers who contract with the health plan.
Maternity care – Includes medically necessary pregnancy counseling, pregnancy testing, prenatal care, labor and delivery services, as well as care after delivery.
Maternity care coordination – Coordination of the mother’s needs to ensure she and her baby receive all the necessary care for a healthy pregnancy and delivery.
Medical Necessity – This term refers to the need for health care services or products that a doctor would give to a patient to prevent, diagnose, or treat an illness, injury, disease or its symptoms in a way that follows generally accepted standards for medicine and is not just for the convenience of the patient, physician or other health care provider.
Member – An eligible person enrolled in Health Choice Arizona.
Personal Health Information (PHI) – PHI includes information about a member’s health care, such as physical and mental health, as well as payments for health care.
Postpartum care – Health care provided to the mother for up to 60 days after delivery.
Practitioner – Generally, refers to a certified nurse practitioner, midwife, or physician assistant.
Prenatal care – Health care provided during the pregnancy.
Prescription – A doctor’s written instructions for medication or treatment.
Primary Care Physician (PCP) – The doctor who treats the member directly. PCPs are usually family practitioners, internists or pediatricians.
Prior Authorization – Some medical procedures, surgeries, equipment and services require your primary care physician or specialist to contact Health Choice Arizona prior to determining if this service is appropriate for your care.
Provider – A person or facility that provides health care services and treatment such as a doctor, pharmacy, dentist, clinic or hospital.
Referral – Your primary care physician (PCP) may be required to you or your family member a referral for certain specialists or procedures. The referral can take the form of a document that you must bring to the specialist or facility that your PCP has referred you to. The referral tells the specialist or facility that you have seen the PCP for your condition and that additional health care services may be recommended. The referral also tells Health Choice Arizona that your PCP has referred you to a specialist or facility in the Health Choice Arizona network.
Seriously and Persistently Mentally Ill (SPMI) – Any person who, as a result of a serious mental disorder, has emotions or behaviors that prevent them from performing everyday activities.
Special Health Care Needs – Patients who have serious and chronic physical, developmental or behavioral conditions who require a special type or amount of care.
Specialist – Any doctor who has special training for a specific condition or illness.
Urgent Care – Care provided to patients when their condition is not life threatening, but cannot wait until the next business day for treatment.
Women, Infants and Children (WIC) – A community program that provides food, nutrition counseling and access to health services to low income women, infants and children.