Arizona Provider Enrollment - Frequently Asked Questions
Who needs to enroll in Arizona Medicaid?
Any provider who would like to receive Medicaid reimbursement for services rendered to Arizona Medicaid recipients. This includes rendering and billing providers, groups, and facilities.
How do I enroll?
Providers can complete the registration process by visiting the Arizona Health Care Cost Containment (AHCCCS) website below: https://www.azahcccs.gov/PlansProviders/NewProviders/registration.html.
What information do I need?
- Name, date of birth, Social Security Number, and home address of each person with ownership or control interest in the provider.
- Name, Federal Employer Identification Number, and applicable addresses for each entity with ownership or control interest in the provider.
- Internal Revenue Service (IRS) document showing the provider's name and tax identification number.
- Professional or facility license number, as appropriate.
- National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES), as appropriate.
- Documentation of any adverse actions involving:
- Criminal History,
- Disciplinary action against any license,
- Denial, termination, exclusion, suspended payments, or unpaid fines from Medicare or Medicaid in this or any state.
- Required elements:
- Copy of Professional License,
- Copy of NPI Registration Form,
- Proof of TAX ID.
How long does it take to hear back from enrollment?
Enrollment can take up to 30 or more days to complete.
Who should I contact with further questions?
For questions regarding the provider enrollment process, please contact the AHCCCS Provider Enrollment Unit.
- 1-602-417-7670 Option 5 (calling from Maricopa County)
- 1-800-794-6862 (calling from in-state, but outside of Maricopa County)
- 1-800-523-0231 (calling from out of state)
For questions concerning why Envolve has requested you take action, please contact Customer Service at 1-844-876-2028.