Provider Updates 

Provider Updates

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Change to Risk Level for Provider Type A3 and 2025 Provider Enrollment Application Fee

December 12, 2024

Change to Community Service Agency (PT A3)

In accordance with 42 CFR 455.450(e)(2), the risk level for Community Service Agencies (Provider Type A3) has been changed to high risk effective 12/09/2024. Due to the change in risk level, a Fingerprint-Based Criminal Background Check is required for all new and pending applications, as well as revalidations.

2025 Provider Enrollment Application Fee

The Centers for Medicare and Medicaid Services (CMS) have issued the 2025 Provider Enrollment application fee amount. The enrollment fee for calendar year 2025 is $730, effective January 1, 2025 through December 31, 2025.

For more information on Provider Enrollment application fees, see Provider Enrollment Policy Manual, chapter 105 and the AHCCCS Provider Enrollment Portal (APEP) under Provider Enrollment Application Fees.

APEP System Issue Resolved

December 12, 2024

Yesterday, a communication was sent about a system issue impacting the AHCCCS Provider Enrollment Portal (APEP). Emails were not being sent for new APEP logins or requests to reset a password. The issue has been resolved and providers should be receiving emails as expected.

APEP Not Sending Password Reset or Account Creation Emails

December 11, 2024

AHCCCS is aware of a system issue that is impacting the AHCCCS Provider Enrollment Portal (APEP). Currently when a user establishes a new APEP login OR requests a password reset, the emails are not being sent to allow the user to take the intended action.

AHCCCS is working to get the issue corrected as soon as possible and will send a follow-up communication when the issue has been resolved.

The new Provider Enrollment Policy Manual is now available

December 1, 2024

AHCCCS is committed to improving service to providers. A new Provider Enrollment Policy Manual is now available and can be found on the AHCCCS Provider Enrollment website. The direct link to the new tool can be found here: Provider Enrollment Policy Manual.

Providers are encouraged to review the AHCCCS Provider Enrollment Policy Manual. A training video will be available to you on the APEP page of azahcccs.gov in the Resources section.

The Provider Enrollment Policy Manual is a tool for providers to help determine requirements when applying to become an AHCCCS enrolled provider.

Key features of the Provider Enrollment Policy Manual:

  • This comprehensive manual offers specific provider enrollment screening criteria such as screening activities by risk level, requirements for fingerprint based criminal background checks, site visits and more!
  • Chapter 111 of the manual describes requirements specific to each available AHCCCS Provider Type. Each section identifies risk level, requirements for site visits, fingerprinting, and required license and certification. Additionally, each section identifies what categories of service (COS) are available for each provider type and what license or certification is required to get the COS.
    Provder Type List
  1. Introduction
  2. Group Biller
  3. Hospital
  4. Pharmacy
  5. Laboratory
  6. Clinic
  7. Emergency Transportation
  8. Dentist

Please note that this enrollment manual does not replace or implement any new requirements than what is set forth in the AHCCCS Medical Provider Manual (AMPM) chapter 610. This tool is to assist providers in understanding enrollment requirements that are supported in AHCCCS Policies and Procedures.

New Provider Enrollment Tool Coming Soon!

November 27, 2024

AHCCCS is committed to improving service to providers. A new Provider Enrollment Policy Manual will be available beginning 12/01/2024 and will be available on the AHCCCS Provider Enrollment website (https://www.azahcccs.gov/APEP).

This new tool is a comprehensive manual that offers specific provider enrollment screening criteria such as screening activities by risk level, requirements for fingerprint based criminal background checks, site visits and more! The new manual will also give provider type-specific requirements for screening and enrollment.

Please note that this enrollment manual does not replace or implement any new requirements than what is set forth in the AHCCCS Medical Provider Manual (AMPM) chapter 610. This tool is to assist providers in understanding enrollment requirements that are supported in AHCCCS Policies and Procedures.

New Step for Rendering Providers

September 25, 2024

New Step Require for Individual Rendering/Servicing Providers.

AHCCCS recently implemented a system change in the AHCCCS Provider Enrollment Portal which requires action to be taken for applying rendering/servicing providers. The document below outlines what is expected at this new step of the application process.

Name Change to Provider Type A4- Licensed Independent Substance Abuse Counselor

September 23, 2024

Effective 09/14/2024, as a result of SB1062 the title "Licensed Independent Substance Abuse Counselor" (LISAC) changed to "Licensed Independent Addiction Counselor". As a result, AHCCCS changed the name of the provider type to match the new license title. The provider type for AHCCCS Provider Enrollment will remain “A4” and reflect the new title.

Since this is only a name change, providers with an A4 provider type will not be required to do anything to update their AHCCCS records. AHCCCS is not requiring providers to take any action on their AHCCCS Provider Enrollment, as it relates to the title name change.

The new title will present in the AHCCCS Provider Enrollment Portal (APEP) as follows:

Previous:

LIC INDEP SUBSTANCE ABUSE COUNS (LISAC)

New:

LIC INDEP ADDICTION COUNS (FORMER LISAC)

Provider Revalidations

August 14, 2024

All providers are required to revalidate their enrollment at least every four years. When it is time to revalidate, providers are sent a notification 90 days before the revalidation is required to be completed.

The file below is a list of providers who are currently required to revalidate their enrollment and the due date for their revalidation. Failure to revalidate may result in termination of enrollment with AHCCCS.

New Resources for Provider Enrollment

May 29, 2024

To improve service to providers, AHCCCS has recently released many new and helpful resources on the Provider Enrollment website.

These resources include:

Providers are encouraged to check the AHCCCS web page regularly for other helpful resources.

Provider Domain Transfers

February 22, 2024

Providers Must Take Action to Resolve an APEP Domain Transfer Before Contacting AHCCCS (Effective February 22, 2024)

Due to significant security concerns, AHCCCS froze call center agent-assisted domain transfers in January 2024.

A domain transfer, or domain access, is when access to a provider’s AHCCCS Provider Enrollment Portal (APEP) application is granted to another person. For example, when an individual provider begins working for a new organization, the new organization may need to be given domain access to update the individual provider’s associations.

To resolve a domain transfer issue, the provider is responsible for working with their previous employer or credentialist to have their APEP profile released.

In the rare instance when a provider has made a good faith attempt to contact the previous employer but has been unsuccessful, AHCCCS will assist with the domain transfer process in one of two ways:

  1. The Provider Services Call Center will, upon request, provide the name and/or organization of the current domain owner so the provider can resolve the issue with the current domain holder,

    OR

  2. Provider Enrollment will complete the domain transfer via a ticket. The Provider Services Call Center cannot complete Domain Transfers. Calling the Provider Services Call Center will not expedite a response.

    Submit a ticket by email to APEPTrainingQuestions@azahcccs.gov with the subject “Domain Transfer.” Include a letter signed by the individual provider requesting the domain transfer. The letter must contain the following information:
    1. Provider’s Name,
    2. Provider’s AHCCCS ID,
    3. Provider’s NPI,
    4. Provider’s Last 4 of SSN,
    5. Provider’s DOB,
    6. Name of the current domain holder
    7. APEP username of the person who needs domain access
    8. Explanation what has been done to work with the current domain owner to resolve the situation, and
    9. Copy of the provider’s driver’s license or official state ID.

AHCCCS will prioritize tickets that have a subject line of “Domain Transfer”, with a goal of responding within 10 days. If you do not include all the information listed above, the ticket will be closed and you will need to submit a new, complete ticket.

AHCCCS will provide additional information about the Domain Transfer process in the coming weeks. Please watch for an email from us, look for a web page update, and subscribe to Provider Enrollment email news alerts.

Group Biller Address Update - Clarification

February 21, 2024

Given the level of concern regarding the Group Biller Services Address Update letter that was mailed to registered group billers on February 2, 2024, AHCCCS has made the decision to hold the APEP system release that was scheduled to go into effect on February 18, 2024.

The planned system change is for the purpose of cleaning up service addresses listed on Group Biller profiles in APEP. New enrollment applications are not needed as a result of this system change. The change will not impact the ability to bill, be paid, or any existing billing processes.

Over the coming weeks, AHCCCS will be offering additional opportunities for Group Billers to better understand the system change.

Group Biller Application Changes Update and Resources

February 16, 2024

AHCCCS Provider Enrollment thanks providers who were able to attend the open-door Zoom meeting to review the upcoming changes to services addresses on Group Biller applications in the AHCCCS Provider Enrollment Portal (APEP). The system changes are effective 02/18/2024.

For those who were unable to attend the meeting or would like to review the information again, the following resources are now available:

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