Resources: Provider Enrollment Policy Manual, Screening Glossary, and Trainings


Provider Enrollment Policy Manual

The Provider Enrollment Policy Manual contains all policy related to provider enrollment with AHCCCS.

Provider Enrollment Screening Glossary

The Provider Enrollment Screening Glossary is a tool to help determine the following screening requirements:

When reviewing the Provider Enrollment Screening Glossary (PEP-903), it’s important to select the correct enrollment type at the initial enrollment submission. Outlined below are definitions of the available enrollment types listed within the glossary.

  • Individual – Regular Individual/Sole Proprietor or Rendering/Service Provider,
  • Group Biller - This enrollment type acts as a “Group Biller Only” provider type 01 (an organization electing to act as a financial representative for any provider or group of providers),
  • Facility/Agency/Organization (FAO-Hospital, Nursing Facility, Various Entities),
  • Contractor/MCO – Managed Care Organization,
  • Atypical (non-medical) provider (Choose this option if you do not have a NPI),
    • Individual (Driver, Home Help/Personal Care, Carpenter, etc.),
    • Agency (Child Care Institution, Home Help/Personal Care Agency, Transportation Company, etc.)

    Trainings

    Features of the PEPM

    How to Establish a New User Single Sign-on

    New Enrollment

    How to Enroll Based on Provider Types

    These instructional, step-by-step documents are designed to teach providers how to enroll within the AHCCCS Provider Enrollment Portal (APEP).

    Use the Provider Enrollment Screening Glossary (PEP-903) to determine which enrollment type is the correct reference document for you.

    For additional information about provider types please email APEPTrainingQuestions@azahcccs.gov.

    How to Report Population Group Sets

    AHCCCS has built a specialized population groups code set to allow for identification of providers that can treat various populations. The creation of the specialized population group identification will be reported in the application submitted in the AHCCCS Provider Enrollment Portal (APEP). Its data will be used for the purpose of identifying providers with specific specialized population groups. Benefits for this identification include opportunities for improved network analysis and eventually a resource for families and members.

    This instructional, step-by-step tutorial is designed to show the provider how to report the population group sets in APEP.

    How to Add a Category of Service

    Category of service is the description of the types of services rendered at a provider type level. Each provider type has certain categories of service available. Some are mandatory and others are optional. Mandatory categories of service are automatically assigned at a provider level and require licensure or certification. Optional categories of service can be added at a provider level based on their enrolled provider type and may require licensure or certification. Optional categories can be added by submitting a ticket.

    The document titled Add a New Category of Service (PEP-906) lists the possible licenses and certifications that may be required for each category of service. Follow the instructions in the document to submit a ticket to add a new category of service.

    Online Training Sessions

    AHCCCS providers can schedule online training sessions with the Provider Enrollment team to learn how to use the AHCCCS Provider Enrollment Portal (APEP). The sessions are conducted over Zoom with a shared screen so you can see how to navigate the APEP system.

    If your organization would like to request additional training on how to enroll in APEP, modify your provider ID, or navigate APEP, schedule a training session. Please send your request for specific training, and your organization’s name and contact information, to APEPTrainingQuestions@azahcccs.gov.

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