DDD billing software built for Arizona agencies
Bill Arizona DDD and the AHCCCS health plans from your own office. SpokeChoice builds each claim from the approved visit, counts its units the way the AHCCCS EVV aggregator does, and checks it against the member's authorization and Arizona's limits before it goes out.
- Claims built from approved visits
- Units that match the EVV record
- Bill in-house, no billing service needed
From approved visit to paid claim
A DDD claim takes several days and two websites to get paid. SpokeChoice keeps track of where every claim is, so nothing is billed early, billed twice or forgotten.
- SignedThe guardian e-signs the visit, or a FOB verifies it
- ApprovedVisits approved together, one 837 line at a time
- Sent to AHCCCSEVV goes to AHCCCS overnight, and the claim waits two business days
- 837 fileBuilt from every ready claim, or a list of what to fix
- AcceptedTA1 and 999 files loaded, and rejected claims reopened
- Paid835 payment files mark each claim paid or denied
Approve on Monday, bill on Wednesday.
What SpokeChoice checks before a DDD claim goes out
Most denials start with a visit that went over a limit, is missing a signature or was set up wrong. SpokeChoice checks at clock-in, again at approval and again when the 837 is built, while each problem is still easy to fix.
Authorizations and ISP limits
Each visit is checked against the member's authorization and the Individual Service Plan's daily and weekly limits. Providers see the latest time they can clock out, and when an authorization changes, the visits not yet billed are checked again.
PPCG and caregiver hours
PPCG care for a child under 18 is held to 40 hours a week, combined across every parent who cares for that child, and caregivers are held to 16 hours in 24. PPCG visits between 10 PM and 6 AM are flagged on the timecard.
Units that match EVV
Billed units are counted per visit from the actual minutes, in 15-minute units with the 8-minute rule, the way the AHCCCS EVV aggregator counts them. The claim doesn't ask for more than its EVV record supports.
Modifiers set for you
Time-of-day modifiers for attendant care, respite and habilitation, PPCG modifiers and group-ratio modifiers come from the visit itself. Respite is billed by the hour (S5150) or by the day (S5151) from the member's total for the day.
Whole days, never billed twice
Visits that bill on the same 837 line are approved together, and a day waits until all of its visits are approved, so a day is never billed in pieces. Duplicate billing is caught before the claim goes out.
Signatures and setup
HCBS visits need the member's or guardian's e-signature unless a FOB was used, and unsigned timecards are listed for reminders. If a claim is missing required information, you get a list of what to fix instead of a bad 837.
Acknowledgments, payments and denials post back to each claim
- Load the TA1 and 999 files, and rejected claims are reopened so you can fix and resubmit them instead of leaving them unpaid.
- Load the 835 payment files, and each claim is marked paid or denied, even when one 837 comes back in several 835s.
- Denied claims go back to Ready, with the payer's reason on the timecard.
- A payment amount lookup helps you reconcile exactly.
- Work outstanding insurance claims from a collections list, and document every call.
Ask why a claim was denied
Open the Denied Claims view, click the robot on a claim and ask what went wrong and what to fix, in plain English. AI Analysis can also review a whole 837 batch and check each service code's billing setup.
Protected health information (PHI) is never sent to the AI.
Bill DDD in-house, or have a partner bill in SpokeChoice for you
Either way, your claims and their history stay in your own SpokeChoice.
Your own office bills
Bill as soon as the AHCCCS wait is over, and see every claim's status yourself, from ready to paid. Your billing person doesn't need to be an expert: the checks above and AI Analysis catch the mistakes.
A partner bills for you
Rather not do it yourself? One of our billing partners can submit your billing in SpokeChoice for you, and you can still see every claim yourself.
Health plans, insurance and centers from the same claims
- Bill AHCCCS health plans, insurance and third-party liability from one place, with each claim routed to the right payer.
- Import DDD authorizations from the WellSky authorization file instead of typing them in.
- Center Billing enters a whole day's claims for a day program or group home, including transportation.
- Over 90 reports and dashboards show where billing slows down and how much of each authorization is used.
DDD billing questions
Can SpokeChoice create the 837 file for DDD?
Yes. SpokeChoice builds the 837 file DDD requires from every claim that is ready to bill in the dates you choose. If something required is missing, you get a list of what to fix instead of a file that would be rejected.
How does SpokeChoice keep claims within the authorization?
Visits are checked against the member's authorization and the ISP's daily and weekly limits at clock-in, at approval and before billing. Providers are told the latest time they can clock out, and a claim's units are never set above the remaining balance; anything over is flagged for the office to fix.
Do SpokeChoice claims match the EVV record?
Yes. Approved visits are sent to the AHCCCS EVV aggregator automatically, and billed units are counted per visit from the same times AHCCCS receives, in 15-minute units with the 8-minute rule. Claims wait until their visits have been with AHCCCS for two business days.
Does SpokeChoice handle PPCG billing?
Yes. PPCG care for a child under 18 is held to 40 hours a week, combined across every parent who cares for that child, PPCG modifiers are added to the claim, and PPCG visits between 10 PM and 6 AM are flagged on the timecard.
What happens when a DDD claim is denied?
Denials are rare, because every claim is checked before it goes out; most that do happen come from a temporary issue with a payer's or AHCCCS's systems. When one does, loading the 835 payment file marks the claim denied and sends it back to Ready, with the payer's reason on the timecard. Ask AI Analysis what the denial means and what to fix, then bill it again.
Do I need a billing service to bill DDD?
No. SpokeChoice is built so your own office can bill DDD itself. If you would rather not, one of our partners can submit your billing in SpokeChoice for you, and you can still see every claim yourself.
Can SpokeChoice bill AHCCCS health plans and insurance too?
Yes. Bill Arizona DDD, AHCCCS health plans, insurance and third-party liability from one place, and import DDD authorizations from WellSky instead of typing them in. Therapy is billed to DDD with no separate spreadsheets to keep, and waivers from DDD are part of the process, so there's far less manual work.
Can SpokeChoice bill for therapy or long-term care?
Yes. Arizona therapy agencies and ALTCS EPD long-term care agencies bill with SpokeChoice. It handles each payer's billing process, including submitting through a clearinghouse, at no extra charge.
See your own DDD billing in SpokeChoice
In a free demo we'll walk through billing with your own services and payers, from the approved visit to the 837 and the payment file, and show you what your office gets back.
Book a demoBook a demo, and ask us about switching
We'll show you SpokeChoice with your own workflows and walk through how your agency would move over. This form goes straight to our sales team.
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