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MEDICAL PROVIDER INQUIRY FORM

Effective October 1, 2020, the Alliance has changed our processes to streamline bill submission, medical bill review, and payment issuance. Billing inquiries are being handled by Mitchell; they can be contacted at 800.732.0153. Please submit all paper medical bills and supporting documentation (including reconsiderations) for bill review via fax (858.586.244) or to the following address:

The Arizona School Alliance for Workers’ Compensation, Inc.
P.O. Box 2882
Clinton, IA 52733-2882

Please note that Arizona workers’ compensation law allows the carrier 30 days from the date of receipt to process medical billings for payment (provided the claim is accepted and all required information is provided).