Arizona Health Care Cost Containment System Provider Registration Form

Alien registration cards if there are non u s.

Arizona health care cost containment system provider registration form.

Ahcccs stands for arizona health care cost containment system and it is the state of arizona s. Provider enrollment unit po box 25520 md 8100 phoenix az 85002. Arizona health care cost containment system ahcccs attn. 1 800 654 8713 outside maricopa county.

Southern arizona at 866 495 6738. Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics. For more information contact the rbha in your area. Arizona health care cost containment system quickstart guide registration account management registration account management as provider 3 step3.

Web form cqm azahcccs gov 602 417 4885. This system contains state of arizona and u s. Your co payment amount will vary. Central arizona at 800 564 5465.

Arizona health care cost containment system application instructions. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps. Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents.

You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus. General administration questions other contacts. Northern arizona at 800 322 8670. 602 417 4000 in state toll free.

Collect money we overpaid to you in the form of benefits. Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system. Individuals must meet certain income and other requirements to obtain services. A co payment is the amount you pay a health care provider when you receive a medical service.

You may use only one application form to apply for everyone in your family. 1 800 654 8713 outside maricopa county. Once the business type is selected the boxes for the corresponding. 602 417 4000 in state toll free.

Provider enrollment services available online arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents. This information is confidential under state and federal law. Citizens applying for benefits in your household. Arizona long term care system altcs offices.