AHCCCS Provider Enrollment Portal

FAQs


FAQs

  • A1: What is APEP?

    AHCCCS Provider Enrollment Portal (APEP) is an online electronic portal that streamlines the provider enrollment process for new providers when they submit initial applications. APEP also helps existing providers maintain their provider ID through a modification request.

  • A2: Who can access APEP?

    All providers or persons authorized on the provider’s behalf will be able to use APEP for their enrollment process needs.

  • A3: Does APEP apply to all providers?

    Yes, this system applies to all prospective and AHCCCS registered providers, regardless of provider type.

  • A4: Can providers receive training on the APEP system?

    AHCCCS has an APEP training plan and registration instructions posted under APEP training. APEP training can also be conducted upon request. Please visit azahcccs.gov/APEP.

  • A5: Is there new data being collected within APEP?

    Yes, there are new required data elements in APEP. These include:

    • Home Address
    • Email Address(es)
    • Hours of Operation
    • Handicap Accessible
    • Languages Spoken, and
    • Taxonomy - A taxonomy number defines a provider’s area

  • A6: Will the paper-based application be available to providers with limited access to the internet?

    The paper-based application will continue to be available for persons who don’t have access to the internet based portal. However, we recommend using APEP as it will generate the submitted request to AHCCCS in real time. The paper-based Provider Enrollment application currently posted on the APEP website aligns with APEP.

  • A7: Will all providers be expected to revalidate within APEP?

    With the launch of APEP, all providers are expected to access the system and validate their information. This process is referred to as “re-registration.” For some providers, the re-registration process will be considered the revalidation application. Providers will be notified through the United States Postal Service when it’s time to complete the re-registration process. For the re-registration plan, please visit azahcccs.gov/APEP.

  • A8: If I am an existing provider or a prospective provider, what do I need to do?

    Create a Single-Sign-On (SSO) to access APEP. Review APEP training tutorials and videos posted at azahcccs.gov/APEP.

  • A9: What is a Single-Sign-On (SSO) and how is it used?

    The Single-Sign-On (SSO) is the username and password a user is required to establish to gain entry in APEP.

  • A10: How do I reset my password for my SSO?

    Review the tutorial “Instructions for Resetting a Single-Sign-on Password” at azahcccs.gov/PlansProviders/APEP/Access.

  • A11: I forgot my SSO username. How can I obtain my username?

    Send an email, including the user’s full name and email associated with SSO, requesting the username to APEPTrainingQuestions@azahcccs.gov.

  • A12: Can a SSO be used by multiple APEP users within my organization?

    It’s highly encouraged that every user establishes their own unique SSO.

  • A13: What is the recommended method to create a username for a SSO?

    The username should be unique. Avoid spaces and special characters (i.e. #, !, $, %).

  • A14: Who becomes the Domain Administrator?

    Upon state approval, the user who submits the initial application in APEP becomes the domain administrator.

  • A15: How can a user be granted domain permissions to a provider’s file?

    Contact Provider Assistance (602)417-7670 option 5 or email the NPI and APEP username to APEPTrainingQuestions@azahcccs.gov.

  • A16: What if I don't know who the provider’s Domain Administrator is?

    It does not make a difference. If a user needs access to a provider’s file, email the NPI and APEP username to APEPTrainingQuestions@azahcccs.gov.

  • A17: What is Re-registration?

    Re-registration is the process that providers active prior to August 2020 are required to complete in APEP. Providers must submit an application in APEP with up-to-date information.

  • A18: How do I obtain the temporary 14-digit application ID?

    Contact Provider Assistance at (602) 417-7670, option 5.

  • A19: What does “In Process” mean in APEP?

    “In Process” means the application is currently accessible to the provider to modify.

  • A20: What does “In Review” mean in APEP?

    “In Review” means the application has been submitted to AHCCCS and is awaiting review.

  • A21: If an application is currently “In Review,” what steps are required if additional changes are needed?

    To make changes while an application is In Review, use one of these three options:

    1. Use the “Pull Back” option, if the option is still available on the Business Process Wizard page.
    2. Request the application to be reverted back to “In Process” to allow the updates to occur. Make ONLY your current updates, as the provider could work for other organizations who have made their updates to the application. Resubmit upon completion.
    3. Email the application ID and APEP username with a request to have the application processed and domain permissions granted to the user.

  • A22: What is the “Pull Back” option?

    The “Pull Back” option is an option available to the provider to pull the application back if additional changes are needed. The “Pull Back” field is located on the Business Process Wizard screen once the application has been submitted. The option is only available as long as the application has not been assigned to a state user. If the provider needs to pull the application back and can no longer see the “Pull Back” option, contact Provider Assistance (602) 417-7570, option 5.

  • A23: How can I obtain my “welcome notice” in APEP?
    1. Select the provider domain and use the provider enrollment access profile,
    2. Select My Inbox and Archived Documents,
    3. Change Document Type from ‘all’ to PE Correspondence,
    4. Change ‘Filter By’ to Document Name,
    5. Use percent symbol (%) as a search value, click the Go button,
    6. All documents related to application will appear in list form,
    7. Click the document name hyperlink to view notice as PDF.
  • A24: What is an atypical provider?

    An atypical is a provider that doesn’t provide health care according to 45 CFR Section 160.103. This provider does not require a NPI for enrollment purposes.

  • A25: What if I am considered an atypical provider type but I have a NPI?

    Make a request to add the NPI to your provider ID by sending an email to APEPTrainingQuestions@azahcccs.gov.

  • A26: What is the difference between Render/Servicing and Individual Sole Proprietor?
    • A Render/Servicing provider does not bill Medicaid directly and renders services through a Group, Facility, Agency, or Organization
    • An Individual Sole Proprietor renders services under their own tax identification number.
  • A27: What can I do if my address will not be validated in APEP?

    Email the NPI, provider name, and full address required to be updated and identify the address requiring update: Correspondence, Pay-to or Primary address, to APEPTrainingQuestions@azahcccs.gov.

  • A28: How do I unlock an application ID after five unsuccessful attempts?

    Contact Provider Assistance (602) 417-7670, option 5, request the application ID to be unlocked. Clarify discrepancy by comparing your responses to the provider’s file.

  • A29: How can I confirm my security responses are accurate?

    Contact Provider Assistance (602)417-7670, option 5.

  • A30: Why are my responses to the security questions not correct?

    Responses to the security questions were converted from the AHCCCS legacy system. An incorrect response could be the result of a typo in our main system or old data.

  • A31: Am I able to begin a new enrollment and complete the application at a later time?

    Yes, as long as Step 1 is marked as “Complete,” the user will be able to access the application ID up to 30 days from the start date.

  • A32: I started the incorrect enrollment type. How can I fix it?

    Contact Provider Assistance (602) 417-7670, option 5 to request the application ID to be denied.

  • A33: Does Provider Enrollment have a customer call center?

    Provider Assistance (602) 417-7670, option 5 is the customer service line to contact. Provider Assistance can assist with many provider related questions.

  • A34: What is a service ticket?

    A service ticket is the method of communicating to the Provider Enrollment unit that the provider application requires further research beyond normal Provider Assistance customer service.

  • A35: How can a provider open a service ticket?

    Email APEPTrainingQuestions@azahcccs.gov or contact Provider Assistance (602) 417-7670, option 5.

  • A36: What are the application enrollment types?

    There are five application enrollment types:

    1. Individual,
    2. FAO (Facility, Agency, Organization),
    3. Group Biller,
    4. Atypical Individual,
    5. Atypical FAO.

  • A37: How can I determine under which application enrollment type I should enroll?

    Review the Provider Glossary for the complete list of available provider enrollment types at azahcccs.gov/PlansProviders/APEP/ProviderGlossary.

  • A38: Can I submit my application or modification through a service ticket?

    All applications and or modifications are required to be submitted in APEP.

  • A39: What if I don’t have computer access to submit an application and/or a modification?

    The application can be sent through fax or mail with an explanation of why the paper document is being sent and not submitted in APEP.

  • A40: Why is a service location not added to individuals if part of a group?

    The process of adding a service address has always been at the individual provider id level and has not changed with APEP.

  • A41: How do you complete license/certification (step 5) and upload documents (step 8)? Everything appears to be added but the step remains “Incomplete.”

    Check whether the provider type specialty was marked as ‘board certified.’ If yes, APEP will require the board certificate details in the license/certification step, and will require proof to be uploaded in the upload documents step before steps are considered complete.

  • A42: Why is Step 9: Complete Modification Checklist, and Step 10: Submit Modification Request for Review showing incomplete if the application has been submitted?

    Immediately after initial approval (or modification approval) APEP will reset the ‘Complete Modification Checklist’ step to incomplete. No action is needed when the ‘Complete Modification Checklist’ step is incomplete after initial approval (or modification approval).

  • A43: Why can't the primary “pay to” address be changed? Why is another tax identification number (TIN) required to change primary pay to address?

    APEP users may change pay to addresses while application status is “In Process.” After application approval, AHCCCS must make any “pay to” address changes. Email APEPTrainingQuestions@azahcccs.gov or call Provider Assistance at 602-417-7670, option 5.

  • A44: Why am I receiving a license/certificate notice?

    A license/certificate notice is notifying the provider of a required license/certificate on file set to expire, requesting the provider to upload a current copy of the license/certificate. Failure to take action by the date indicated on the request could lead to termination of the provider id.

  • A45: What steps do I need to take if my provider id was terminated for failure to respond to a license/certificate request?

    Submit the updated license/certificate as a modification request for state review and reinstatement of the provider id.

  • A46: Is retroactive enrollment available in APEP?

    As of April 24, 2023, AHCCCS is no longer approving providers’ requests for a retroactive effective date in the AHCCCS Provider Enrollment Portal. Claims dated prior to a provider’s approval date will not be paid. If a provider feels there is a business justification for allowing a retroactive enrollment date, they may send a request and justification to APEPTrainingQuestions@azahcccs.gov.

  • A47: Who must complete the Fingerprint Clearance Background Check (FCBC)?

    Providers that meet the criteria for criminal background checks as a high-risk to the State Medicaid Program include the following:

    • Individual high-risk providers (such as individual Non-Emergency Medical Transportation providers),
    • Owners of high-risk provider types,
    • A person with a 5 percent or more direct or indirect ownership interest in a high-risk provider.

    Employees who do not meet the criteria above are not required to complete the FCBC. This information can also be found in the AHCCCS Medical Policy Manual, Chapter 610. For information on risk levels by provider type, see the Provider Enrollment Screening Glossary.

  • A48: I own a home health agency which is a high-risk provider type. Do all my employees need to complete the Fingerprint Clearance Background Check (FCBC)?

    No, only owners with 5 percent or more direct or indirect ownership interest are required to complete the FCBC.