Q. What is Revalidation?
A. Revalidation is a process that occurs periodically after enrollment by which a provider is subject to the same screening, disclosures, and as applicable, could include a fee, site visit and Fingerprint-based Criminal Background Check (FCBC) requirements as a new enrollment, and through which a provider shall verify the accuracy of its enrollment information.
Q. How often does a provider complete the Revalidation process?
A. The provider will be required at a minimum to complete the Revalidation process every 4 years from the date of the provider’s original enrollment or last revalidation completion. The State Medicaid Agency has the discretion to revalidate a provider sooner than 4 years.
Q. How is the provider notified when it’s time to revalidate?
A. Two correspondence requests will generate to the provider instructing the provider to submit an application, along with supporting documentation (i.e. License/Certifications, W-9) for the State’s review.
Q. How can a provider determine if a fee, site visit or Fingerprint- based Criminal Background Check are required at revalidation?
A. Refer to the Provider Enrollment Screening Glossary.
Q. How long does the provider have to complete the revalidation forms?
A. The provider has 45 days from the date of the initial request. The provider will receive two correspondence requests. The initial request allows 30 days to comply; a second request will generate 30 days into the revalidation cycle allowing 15 additional days to submit an application.
Q. What happens if the provider doesn’t comply with the revalidation request(s)?
A. The provider ID will terminate, Medicaid billing privileges and access to the AHCCCS Online Portal will be deactivated.
Q. What is the next step if the provider ID is terminated?
A. The provider will be required to submit a complete provider enrollment application pending State’s approval for reactivation of the provider ID.
Q. Can a provider submit the revalidation forms prior to receiving the revalidation request?
A. No, the provider must wait to receive the revalidation notice.
Q. Is the provider notified when the State has completed the review of the submitted revalidation application?
A. Yes, the provider will receive a completion notice. The notification will serve as documentation that the Revalidation process has been completed.
Q. Who should the provider contact for additional questions regarding Revalidation?
A. The Division of Member and Provider Services: