Arizona Provider Enrollment – Frequently Asked Questions

Note: The information provided within this FAQ page is according to the state, unless otherwise indicated (i.e., some areas indicate “According to CMS/Medicaid”).

For full information regarding Provider Medicaid Enrollment in Arizona, please visit the AHCCCS Provider Enrollment Applications and Revalidations page.

For answers to general questions, please review the FAQs below.

Who is required to enroll in the state Medicaid program?

  • Individuals
  • Groups
  • Facility/Agency/Organization (FAO)

I am enrolled as a participating provider in another state’s Medicaid program. Am I also required to enroll in Arizona’s Medicaid Program to provide services to Medicaid beneficiaries?

Yes. All providers billing services for AZ Medicaid members are required to register with the Arizona Medicaid program through the AHCCCS Provider Enrollment Portal (APEP).

How do I enroll?

Navigate to the AHCCCS Provider Enrollment Portal (APEP) website and complete an enrollment application. Paper enrollment applications are accepted in very limited circumstances.

How does my registration relate to billing for services?

You must register with the state using the same identifiers you plan to bill with, i.e., TIN/SSN, Specialty, etc.

The following items must be in alignment:

  • Your contract with Envolve / Centene Dental and Vision
  • State Registration
  • Billing Set Up / Configuration

Are there additional requirements and screenings based on risk / risk level?

According to CMS/Medicaid:

Requirements by Risk Level:

  • All Risk Levels:
    • Verify provider meets any applicable Federal regulations or State requirements for the provider type prior to making an enrollment decision.
    • License Verifications.
    • Conduct database checks.
  • Limited Risks:
    • Site visit.
  • High Risks:
    • Any provider with a payment suspension based on a credible allegation of fraud within the last 10 years.
    • Any provider excluded within the past 10 years by HHS-OIG or a State Medicaid Agency (SMA).
    • Any provider with a qualifying Medicaid overpayment.
    • Providers enrolling within 6 months of the lifting of a temporary moratorium.

States may impose additional screening methods “in addition to or more stringent than” those in the regulations. Providers should check with their SMA to determine their risk category.

Additional requirements based on the provider’s assigned risk level can be found on the AHCCCS website under General AHCCCS Provider Enrollment Requirements.

What is the enrollment application processing timeframe?

  • General Enrollment Application: within 60 days from submission.
  • Expedited Enrollment Application: by email request.

Examples of what may justify an expedite include but are not limited to:

  • Emergent medical needs of AHCCCS members (e.g., transplants or out-of-state emergency services).
  • Department of Child Safety foster parent providers.

What is my Enrollment Effective Date? / How is my Enrollment Effective Date determined?

The enrollment effective date is the date the application is approved.

To request a retroactive enrollment date:

  • Email APEPTrainingQuestions@azahcccs.gov
  • Include:
    • Subject line: “Retroactive Enrollment Date”
    • Provider Name, NPI, TIN, application number, and reason for retroactive enrollment request
    • Supporting documentation (if required)

How do I find proof of registration?

Your “Welcome Notice” is posted on the AHCCCS Provider Enrollment Portal (APEP) under your inbox/archived documents.

I am enrolled but recently received a letter from the State saying that I need to re-enroll, re-register, or revalidate my information. What do I need to do?

Log in to the AHCCCS Provider Enrollment Portal and complete the re-enrollment, re-registration, or revalidation process. The state is required to review your information and complete screening regularly to comply with Federal regulation. Complete all required steps to remain eligible to bill for Medicaid services.

How often do I need to re-enroll, re-register, or revalidate my information?

Providers must re-register their enrollment every four (4) years to maintain Medicaid billing privileges. AHCCCS reserves the right to request off-cycle revalidations. Providers will receive notification by USPS when it is time to complete the re-registration process.

Keep your information up to date!

Report Changes and Maintain Current License and Certifications:

  • Change in Service Address
  • Changes in Ownership or managing employees
  • Maintain current license & certifications
  • Respond to any requests from AHCCCS about your enrollment information

I received a letter from Envolve / Centene Dental and Vision Services about my registration status. What do I do?

Validate your state registration status to confirm if there are any outstanding items needed to activate your registration. Remember, you’re required to revalidate your information regularly with the state. If you have proof of current/valid registration, contact us.

Who do I contact if I have questions about my enrollment/registration or need more information?