Arizona Health Care Cost Containment System Provider Registration Form

Arizona health care cost containment system ahcccs attn.

Arizona health care cost containment system provider registration form. Once the business type is selected the boxes for the corresponding. This system contains state of arizona and u s. Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents. Central arizona at 800 564 5465.

Arizona health care cost containment system quickstart guide registration account management registration account management as provider 3 step3. 1 800 654 8713 outside maricopa county. 1 800 654 8713 outside maricopa county. Ahcccs stands for arizona health care cost containment system and it is the state of arizona s.

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. Northern arizona at 800 322 8670. You may use only one application form to apply for everyone in your family. You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus.

This information is confidential under state and federal law. Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system. Collect money we overpaid to you in the form of benefits. For more information contact the rbha in your area.

602 417 4000 in state toll free. Southern arizona at 866 495 6738. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps. 602 417 4000 in state toll free.

Arizona long term care system altcs offices. Alien registration cards if there are non u s. Arizona health care cost containment system application instructions. Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics.

Your co payment amount will vary. A co payment is the amount you pay a health care provider when you receive a medical service. If eligibility cannot be determined you will be sent a pre populated renewal form with a request. Individuals must meet certain income and other requirements to obtain services.

General administration questions other contacts. Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps. Web form cqm azahcccs gov 602 417 4885. Provider enrollment unit po box 25520 md 8100 phoenix az 85002.