How to Report Fraud, File Quality of Care Complaint, File a Grievance and Filing an Appeal

Reporting Fraud and Quality of Care Complaints

Is one of your providers committing fraud?  Are you not getting help from your support coordinator?  Problems with your provider?  Not getting a service you are approved for?  You have some options.

Reporting Fraud – (From their website)

Here is the link to our webpage on how to report Fraud. https://www.azahcccs.gov/Fraud/ReportFraud/  It’s very easy to get to. We have a Fraud Prevention tab at the top of our home page and when you click on it Report Fraud pops right up. The phone number is easy to remember:

888-ITS-NOT-OK

Reporting Quality of Care Complaints:

AHCCCS: Concerns About the Quality of Care Received

If you have a complaint about a provider or a concern about the quality of care or services you have received, please send an e-mail with your name, AHCCCS identification number, date of birth, phone number, the name of the provider and a short description of the complaint or concern to:

CQM@azahcccs.gov
602.417.4885

Below is the contact information for the Office of Family and Community Resources.(DDD  grievance/complaint contact information) and the Office of Compliance and Review (DDD appeal process contact information).

Family and Community Resources

Front Desk: 602.542.6863
Hotline: 866-229-5553

DDDWeb@azdes.gov 

Office of Compliance and Review-602-771-8163

In addition, Please find the attached Family and Community Resources pamphlet in both English and Spanish to share with families. Please note the Office of Family and Community Resources assist with grievances/complaints and does not assist with the appeal process.

English Flyer
Spanish Flyer

File a Grievance and Appeal with DDD

https://www.azdisabilitylaw.org/wp-content/uploads/2016/04/H8-DDD-Appeals-and-Grievances.pdf

File a Grievance and Appeal with AHCCCCS

https://www.azahcccs.gov/Members/GetCovered/RightsAndResponsibilities/grievanceandappeals.html

Have issues with DDD or your support coordinator? According to DDD:

“You can contact the Division’s Customer Service Dept. so there is timely follow up and notification to the various areas of the Division who will need to address the concerns as it can cross over several depts. Also, the Division’s Customer Service Dept. tracks member situations received and ensures there is resolution. They can be reached at DDDCustomerServiceCenter@azdes.gov or by calling 1-844-770-9500.”