The Provider Enrollment Policy Manual contains all policy related to provider enrollment with AHCCCS.
The Provider Enrollment Screening Glossary is a tool to help determine the following screening requirements:
When reviewing the Provider Enrollment Screening Glossary (PEP-903), it’s important to select the correct enrollment type at the initial enrollment submission. Outlined below are definitions of the available enrollment types listed within the glossary.
These instructional, step-by-step documents are designed to teach providers how to enroll within the AHCCCS Provider Enrollment Portal (APEP).
Use the Provider Enrollment Screening Glossary (PEP-903) to determine which enrollment type is the correct reference document for you.
For additional information about provider types please email APEPTrainingQuestions@azahcccs.gov.
AHCCCS has built a specialized population groups code set to allow for identification of providers that can treat various populations. The creation of the specialized population group identification will be reported in the application submitted in the AHCCCS Provider Enrollment Portal (APEP). Its data will be used for the purpose of identifying providers with specific specialized population groups. Benefits for this identification include opportunities for improved network analysis and eventually a resource for families and members.
This instructional, step-by-step tutorial is designed to show the provider how to report the population group sets in APEP.
Category of service is the description of the types of services rendered at a provider type level. Each provider type has certain categories of service available. Some are mandatory and others are optional. Mandatory categories of service are automatically assigned at a provider level and require licensure or certification. Optional categories of service can be added at a provider level based on their enrolled provider type and may require licensure or certification. Optional categories can be added by submitting a ticket.
The document titled Add a New Category of Service (PEP-906) lists the possible licenses and certifications that may be required for each category of service. Follow the instructions in the document to submit a ticket to add a new category of service.
AHCCCS providers can schedule online training sessions with the Provider Enrollment team to learn how to use the AHCCCS Provider Enrollment Portal (APEP). The sessions are conducted over Zoom with a shared screen so you can see how to navigate the APEP system.
If your organization would like to request additional training on how to enroll in APEP, modify your provider ID, or navigate APEP, schedule a training session. Please send your request for specific training, and your organization’s name and contact information, to APEPTrainingQuestions@azahcccs.gov.
AHCCCS Provider Enrollment Portal (APEP) is an online electronic portal that streamlines the provider enrollment process for new and existing providers when they submit an initial application, revalidation or modification.
All providers and persons authorized on the provider’s behalf can use APEP for their enrollment process needs.
Yes, all providers are required to use APEP for their enrollment, regardless of provider type.
The AHCCCS Provider Enrollment Application form will only be accepted if the provider has extenuating circumstances that explain why they cannot use the AHCCCS Provider Enrollment Portal (APEP).
APEP is strongly recommended as it generates the application to AHCCCS in real time.
A Single Sign On (SSO) is needed to access APEP. To establish a New User SSO: Select, Applying To Be an AHCCCS Provider at https://azahcccs.gov/APEP. Tutorials and videos are posted on this webpage.
The username should be unique. Avoid spaces and special characters (i.e. #, !, $, %).
A Domain Administrator is the user who creates the initial application in APEP. This person is responsible for maintaining the information in APEP, including changes and revalidations.
Upon state approval, the user who submits the initial application in APEP becomes the domain administrator.
An atypical is a provider that doesn’t provide health care according to 45 CFR Section 160.103. This provider does not require an NPI for enrollment purposes.
Make a request to add the NPI to your provider ID by sending an email to APEPTrainingQuestions@azahcccs.gov.
A Render/Servicing provider does not bill Medicaid directly and renders services through a Group, Facility, Agency, or Organization. An Individual Sole Proprietor renders services under their own tax identification number.
To bill with the business tax ID, the business must be registered as a group biller. The rendering/servicing provider must also have a separate individual enrollment, as the servicing provider.
Send an email to:APEPTrainingQuestions@azahcccs.gov Include in the email: .
Yes, if Step 1 is marked as “Complete,” the user will be able to access the application ID up to 30 days from the start date.
Contact Provider Assistance: (602) 417-7670 to request the application ID be denied.
There are six application enrollment types:
Review the Provider Glossary for the complete list of available provider enrollment types.
Not in most cases. More information can be found under Enrollment Effective Dates on the APEP webpage.
Information on processing timeframes can be found on the APEP webpage under Processing Timeframes and Enrollment Effective Dates.
Immediately after approval of any application, APEP will reset the ‘Complete Modification Checklist’ step to incomplete. No action is needed when the ‘Complete Modification Checklist’ step is reset after an application is approved.
Is the provider type specialty marked as ‘board certified?’ If yes, APEP requires the board certificate details in the license/certification step and proof to be uploaded in the upload documents step before steps are considered complete.
In most cases, yes. However, there may be circumstances that cause a new ID to be issued, such as reapplying under new ownership.
FCBC requirements are available on the FCBC information page on the AHCCCS APEP website.
Employees who do not meet the criteria on the FCBC information page are not required to complete the FCBC. This information can also be found in the AHCCCS Medical Policy Manual, Chapter 610. For information on risk levels by provider type, see the Provider Enrollment Screening Glossary.
FCBC requirements are available on the FCBC information page on the AHCCCS APEP website.
FCBC requirements are available on the FCBC information page on the AHCCCS APEP website.
No. You can submit the non-expired fingerprint clearance card with a copy of your valid driver’s license or current United States issued passport instead of completing the FCBC. To submit the information to us, upload the documents in the AHCCCS Provider Enrollment Portal (APEP) using the Upload Documents feature in Step 10.
Yes, you must still complete the FCBC. We can only accept a fingerprint clearance card issued by the Arizona Department of Public Safety along with a copy of your valid driver’s license or current United States issued passport as proof that you previously completed the FCBC.
No. You are not required to get a fingerprint clearance card when you complete the FCBC. The fingerprint clearance card is an alternative to completing the FCBC.
No. You must still complete the FCBC. An FBI background check is not a substitute for the FCBC.
No. You must still complete the FCBC or provide a non-expired fingerprint clearance card issued by the Arizona Department of Public Safety along with a copy of your valid driver’s license or current United States issued passport.
“In Process” means the application is currently accessible to the provider to modify.
“In Review” means the application has been submitted to AHCCCS and is awaiting review by AHCCCS Provider Enrollment.
To make changes while an application is In Review, use one of these options:
The “Pull Back” option is an option available to the provider to pull the application back if additional changes are needed. The “Pull Back” field is located on the Enroll Provider page once the application has been submitted. The option is only available as long as the application has not been assigned to a state user. If the provider needs to pull the application back and can no longer see the “Pull Back” option, email the NPI and APEP username to APEPTrainingQuestions@azahcccs.gov.
Our Provider Services representatives are skilled to provide help to many basic provider questions. To reach Provider Services call: (602) 417-7670.
At the bottom of the AHCCCS/Med-QUEST sign in page it says, “Need help signing in? Click here”. Click on the “Click here” link. Then, follow the instructions.
Send an email, including the user’s full name and email associated with the APEP account, requesting the username to APEPTrainingQuestions@azahcccs.gov.
Every user should establish their own unique SSO.
An existing Domain Administrator for the provider can add other users as a Domain Administrator. See Domain Access in APEP for additional information.
The Provider Services Call Center will, upon request, provide the name and/or organization of the current domain owner. See Domain Access in APEP for additional information.
Contact Provider Services: (602) 417-7670, request the application ID to be unlocked.
Contact Provider Services: (602) 417-7670.
Responses to the security questions were converted from the AHCCCS legacy system. An incorrect response could be the result of a typo in our main system or old data.
APEP users may change pay to addresses while application status is “In Process.” After application approval, AHCCCS must make any “pay to” address changes. Email APEPTrainingQuestions@azahcccs.gov or call Provider Services at 602-417-7670.
A service ticket is the method of communicating to the Provider Enrollment unit that the provider application requires further research beyond normal Provider Services customer service.
Email APEPTrainingQuestions@azahcccs.gov or contact Provider Services: (602) 417-7670.
No, all applications and or modifications are required to be submitted in APEP.
Yes, all providers must revalidate enrollment every four years to maintain Medicaid billing privileges using APEP. AHCCCS reserves the right to request off-cycle revalidations.
A license/certificate notice tells the provider that a required license/certificate on file is set to expire. The provider must upload a renewed copy of the license/certificate before the license/certificate expiry date. Failure to act by the date indicated on the request could lead to termination of the provider ID.
After being terminated for not renewing a license/certificate, a new APEP application is required.
When there is a complete change in ownership for an enrolled organization, the AHCCCS ID under the prior ownership must be terminated. To terminate the prior enrollment, a modification request must be submitted. On the Modification Request Checklist, answer "yes" to the question "Do you wish to end date your enrollment?". After the termination of the prior ID is completed, the new owner must start a new application in the AHCCCS Provider Enrollment Portal.
You can check the status of your application by logging into the AHCCCS Provider Enrollment Portal (APEP). A red message will appear at the top of the APEP screen letting you know the status.
Information on the moratorium, including the affected provider types can be found here.
