You are invited to participate in a survey regarding your experience using the AHCCCS
website. This survey will take approximately two minutes. Your responses will help
us ensure that you have a high quality experience.
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
(Required Fee and-or Site
Visit by Provider Type) [PDF], once the required documents are received and processed.
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.
(Required Fee and-or Site
Visit by Provider Type) [PDF]
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:
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
Q. Where can providers send the completed forms?
A. Mail or fax completed and signed registration forms.
Q. How long will it take for Provider Registration to process the
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.
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