Arizona health care cost containment system application instructions.
Arizona health care cost containment system provider registration form.
Citizens applying for benefits in your household.
You may use only one application form to apply for everyone in your family.
Arizona health care cost containment system ahcccs is arizona s medicaid agency that offers health care programs to serve arizona residents.
Individuals must meet certain income and other requirements to obtain services.
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.
General administration questions other contacts.
Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.
This system contains state of arizona and u s.
Central arizona at 800 564 5465.
Once the business type is selected the boxes for the corresponding.
Apply personally at a local faa office at the department of economic security des office at the hospital or at certain clinics.
For more information contact the rbha in your area.
Arizona health care cost containment system quickstart guide registration account management registration account management as provider 3 step3.
Your co payment amount will vary.
Include alien registration cards.
Arizona health care cost containment system ahcccs attn.
Alien registration cards if there are non u s.
Arizona long term care system altcs offices.
1 800 654 8713 outside maricopa county.
Ahcccs 801 e jefferson st phoenix az 85034 find us on google maps.
602 417 4000 in state toll free.
This information is confidential under state and federal law.
After selecting the i agree and clicking on the next button user can select the business type on the following screen.
You can apply online for ahcccs medical assistance nutrition assistance and cash assistance using health e arizona plus heaplus.
1 800 654 8713 outside maricopa county.
If eligibility cannot be determined you will be sent a pre populated renewal form with a request.
Southern arizona at 866 495 6738.
602 417 4000 in state toll free.
Use and disclosure of this information is limited to purposes directly related to the administration of the arizona health care cost containment system.
Web form cqm azahcccs gov 602 417 4885.
A co payment is the amount you pay a health care provider when you receive a medical service.
Provider enrollment unit po box 25520 md 8100 phoenix az 85002.
