AHCCCS Provider Enrollment/Application Fee

Online Provider Enrollment/Application Fee Guidelines

Making an Online Provider Enrollment/Application Fee payment is a free service offered through AHCCCS. This service is designed in accordance with the Affordable Care Act, effective January 1, 2012 for AHCCCS Administration to collect an enrollment/application fee for required provider types.

Select one of the following for information:

Payment Options

You can use a Visa, Master Card, American Express, Credit/Debit Card, or enter a bank account number to make a payment. For the bank account payment option, you will need your account number and the bank routing number. Cash, checks and money orders are not acceptable forms of payment.


Payment Scheduling Information

Please read the following scheduling information

It is recommended that you schedule payments at least 3 business days before the actual due date.

  • Same Day Processing: Complete your payment request by 5:00 pm (PT).

  • Next Business Day Processing: Complete your payment request after 5:00 pm (PT).

  • Weekend/Federal Holidays:
    • Weekend and Federal Holiday dates are not available payment request dates for this online payment service.
    • If you schedule a payment for Saturday, Sunday, or for a Federal Holiday, the payment will be processed the following business day at 5:00 pm (PT).

Login to Use the Online Payment Service

To login to use the Online Premium Payment service, confirm you have read, understood, and agree to abide by the guidelines, then select I Agree and follow the directions.

Note: If you select I Disagree you cannot make online payments.

Acknowledgment

Select the appropriate link below to indicate your agreement or disagreement with the AHCCCS Online Provider Enrollment/Application Fee Guidelines.

I agree | I disagree

 

Contact Us

Call Center hours are Monday through Friday 10am - 4pm (ARIZONA TIME)

  • For Online Provider Enrollment/Application Payment Questions:
    • Call:
      • Maricopa County: 602-417-4254
      • Statewide: 1-888-827-4420
  • Write:
    AHCCCS Provider Enrollment Fee
    701 E. Jefferson, MD 5400
    Phoenix, AZ 85034