Returning to Normal Provider Enrollment

Enrollment Processes Reinstated As of April 24, 2022

Since the beginning of the COVID-19 public health emergency, AHCCCS has suspended several requirements of new and existing providers. Effective April 24, 2022 these requirements will be reinstated. If an action is required from you to maintain your provider ID, expect to receive a written correspondence over the next several months that outlines what action is required.

Some AHCCCS providers will receive written notification to revalidate their application and meet additional screening requirements based on their provider type. Providers that have an expired license will be notified in writing to submit the current license or certification. Providers that have not responded to the re-registration invitation will be notified in writing to complete a revalidation application. Failure to complete the revalidation application could result in disenrollment and claim denials.

Providers with questions, or those who are no longer participating as a Medicaid provider or no longer employed with an organization, are asked to contact

Temporary Enrollment for Out-of-State Providers

In order to ensure out-of-state providers are reimbursed, AHCCCS requests these providers to complete and submit a shortened Provider Enrollment form. This form will only authorize “temporary” enrollment of an out-of-state provider during the public health emergency. Providers seeking long-term enrollment must follow the AHCCCS Provider Enrollment Portal (APEP) process.

Please fax the completed application to (602) 256-1474.