Out of State Enrollment During COVID-19

Enrollment Processes during COVID-19

Due to the evolving COVID-19 pandemic and Governor Ducey’s directive to socially distance in order to reduce the spread of the virus, AHCCCS staff have transitioned to work alternative methods such as telework as much as possible. In order to successfully continue to meet the needs of our Provider community, we ask providers to contact us by email with any provider enrollment related questions. AHCCCS will respond within 24 hours. We ask providers to fax or email all provider-related applications and verifications. We receive faxes electronically and can continue to distribute these documents for timely processing. Thank you for your patience as we shift our work environments while maintaining our commitment to and standards of timely provider enrollment service.

Fax (Preferred Method): 602-256-1474


Email: PRNotice@azahcccs.gov

In reference to the COVID-19 pandemic, a public health emergency has been executed. In order to ensure Out-of-State providers are reimbursed AHCCCS is requesting a shorten Provider Enrollment form to be completed and submitted for approval. This form is only to be utilized for “temporary” enrollment of an Out-of-State provider during the public health emergency. For all other provider enrollment providers please refer to the AHCCCS Provider Enrollment Form under the “Individuals/Companies/Facilities” packet.