AHCCCS Provider Reenrollment 

On Sunday 01/21/2018 from 4:00 AM to 12:00 PM (noon), some of AHCCCS services will not be available due to scheduled maintenance.

Provider Reenrollment

In compliance with the Affordable Care Act and 42 CFR 455, Subpart E, and as a part of the provider registration process, all providers registered with AHCCCS are required to reenroll. The required reenrollment forms will be listed on the notices that will be sent. The notices will direct providers to the AHCCCS website to retrieve applicable forms.

Designated provider types will be notified of payment and site visits requirements, once the required documents are received and processed.

Required Fee and-or Site Visit by Provider Type

Q. What is reenrollment?
A. Reenrollment is the completion of the provider registration process and paying the enrollment fee. The enrollment fee and site visits only apply to certain providers types.

Q. When will reenrollment begin?
A. Reenrollment of providers will begin in January 2013.

Q. When do I have to make my Fee Payment to AHCCCS?
A. Notification will be sent which will include payment requirements.

Q. When should providers start completing and submitting the forms?
A. Providers who were registered with AHCCCS prior to 01/01/2012 will be notified by mail or e-mail when it is time to reenroll. The notice will list the required forms and will direct providers to the Provider Registration website to retrieve all forms. All forms must be submitted by the indicated time frame on the letter or the AHCCCS identification number will be terminated for failure to reenroll.

Federal regulations prohibit an unverified provider to participate in the AHCCCS program. As a terminated provider you will not be eligible to receive payment for services rendered to fee-for-service recipients or provide services under contract with a prepaid health plan or program contractor.

Forms can be located at: http://www.azahcccs.gov/PlansProviders/NewProviders/packet.html

Q. Who can complete the forms?
A. The requirements for completing the forms have not changed. Individual providers must complete and sign the forms. Forms may be completed by authorized signers on file with AHCCCS. The forms for companies/facilitates and groups may be signed by the CEO, CFO Administrator, Owner, Executive Director, President or Vice President.

Q. Can providers submit the forms before receiving a reenrollment notice?
A. No. Providers must wait to receive a reenrollment notice. If documents are received prior to the reenrollment notices are mailed out, the documents will be processed as regular updates due to system requirements.

Q. Where can providers send the completed forms?
A. Mail or fax completed and signed registration forms.

  • Mail:
    AHCCCS Provider Registration
    P.O. Box 25520, Mail Drop 8100
    Phoenix, AZ 85002
  • Fax:
    Attn: AHCCCS Provider Registration
    602 256-1474

Q. How long will it take for Provider Registration to process the reenrollment forms?
A. All forms are usually processed within 15 business days, if everything is complete and signed correctly. However, some updates may take longer than 15 business days depending on the volume of documents received. Please allow ample time to confirm if forms were received. When forms are faxed in, it usually takes 24 hours for the forms to appear in the system.

Q. How will providers know they are completed with the reenrollment process?
A. All providers will receive a reenrollment completion letter. The letter should serve as notification that the reenrollment process has been completed.

Provider types that require an enrollment fee and site visit will then be notified for fee payment. When the fee is paid and the site visit has been conducted a letter will be mailed notifying the provider that the reenrollment process has been completed.

Please reference to the list above that lists the provider types that require an enrollment fee and site visit. Providers that do not require an enrollment fee and site visit should receive a letter once all completed documents are received and processed.

Q. Who to Contact with Questions
A. For questions regarding the provider registration process, please contact the AHCCCS Provider Registration Unit.

  • Call:
    • In Maricopa County: 602-417-7670 and select option 5
    • Outside Maricopa County: 1-800-794-6862
    • Out-of-State: 1-800-523-0231
  • Write:
    Arizona Health Care Cost Containment System (AHCCCS)
    ATTN: Provider Registration Unit
    PO Box 25520, MD-8100
    Phoenix, AZ 85002
Can't find what you're looking for? Please visit the AHCCCS Document Archive.
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