Citizens applying for benefits in your household.
Arizona health care cost containment system provider registration form.
Your co payment amount will vary.
602 417 4000 in state toll free.
A co payment is the amount you pay a health care provider when you receive a medical service.
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.
602 417 4000 in state toll free.
Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents.
Web form cqm azahcccs gov 602 417 4885.
Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.
Arizona health care cost containment system ahcccs attn.
Arizona health care cost containment system quickstart guide registration account management registration account management as provider 3 step3.
Collect money we overpaid to you in the form of benefits.
Arizona long term care system altcs offices.
Provider enrollment unit po box 25520 md 8100 phoenix az 85002.
Individuals must meet certain income and other requirements to obtain services.
Alien registration cards if there are non u s.
This information is confidential under state and federal law.
General administration questions other contacts.
Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system.
You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus.
You may use only one application form to apply for everyone in your family.
This system contains state of arizona and u s.
Arizona health care cost containment system application instructions.
After selecting the i agree and clicking on the next button user can select the business type on the following screen.
If eligibility cannot be determined you will be sent a pre populated renewal form with a request.
Northern arizona at 800 322 8670.
Central arizona at 800 564 5465.
Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.
For more information contact the rbha in your area.
Southern arizona at 866 495 6738.
Ahcccs stands for arizona health care cost containment system and it is the state of arizona s.
Include alien registration cards.
Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics.
