Arizona Health Care Cost Containment System Provider Registration Form

1 800 654 8713 outside maricopa county.

Arizona health care cost containment system provider registration form.

Provider enrollment services available online arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents. 1 800 654 8713 outside maricopa county. If eligibility cannot be determined you will be sent a pre populated renewal form with a request. Arizona long term care system altcs offices.

Your co payment amount will vary. Citizens applying for benefits in your household. Collect money we overpaid to you in the form of benefits. For more information contact the rbha in your area.

General administration questions other contacts. Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system. Ahcccs stands for arizona health care cost containment system and it is the state of arizona s. This information is confidential under state and federal law.

You may use only one application form to apply for everyone in your family. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps. This system contains state of arizona and u s. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.

Arizona health care cost containment system quickstart guide registration account management registration account management as provider 3 step3. After selecting the i agree and clicking on the next button user can select the business type on the following screen. 602 417 4000 in state toll free. Once the business type is selected the boxes for the corresponding.

Alien registration cards if there are non u s. You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus. Provider enrollment unit po box 25520 md 8100 phoenix az 85002. Central arizona at 800 564 5465.

Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics. Web form cqm azahcccs gov 602 417 4885. Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents. 602 417 4000 in state toll free.

Southern arizona at 866 495 6738. Arizona health care cost containment system ahcccs attn. Arizona health care cost containment system application instructions. Include alien registration cards.