This system contains state of arizona and u s.
Arizona health care cost containment system provider registration form.
Arizona long term care system altcs offices.
Web form cqm azahcccs gov 602 417 4885.
Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents.
Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.
Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics.
General administration questions other contacts.
602 417 4000 in state toll free.
Arizona health care cost containment system ahcccs attn.
You may use only one application form to apply for everyone in your family.
Northern arizona at 800 322 8670.
Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system.
Include alien registration cards.
1 800 654 8713 outside maricopa county.
This information is confidential under state and federal law.
Ahcccs stands for arizona health care cost containment system and it is the state of arizona s.
Provider enrollment unit po box 25520 md 8100 phoenix az 85002.
Your co payment amount will vary.
If eligibility cannot be determined you will be sent a pre populated renewal form with a request.
Alien registration cards if there are non u s.
Citizens applying for benefits in your household.
602 417 4000 in state toll free.
You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus.
Central arizona at 800 564 5465.
Arizona health care cost containment system application instructions.
Collect money we overpaid to you in the form of benefits.
Southern arizona at 866 495 6738.
After selecting the i agree and clicking on the next button user can select the business type on the following screen.
Provider enrollment services available online arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents.
A co payment is the amount you pay a health care provider when you receive a medical service.
Once the business type is selected the boxes for the corresponding.
Individuals must meet certain income and other requirements to obtain services.
1 800 654 8713 outside maricopa county.
