For more information on the ACOM 407 Attachment A Requirement Survey, please click here.

About the AzAHP Credentialing Alliance

Healthcare providers that want to serve patients in the Arizona Health Care Cost Containment System (AHCCCS) must join a health plan, and our Credentialing Alliance outlines the steps required to do so. All AHCCCS health plans participate in the Alliance, and we continually work to standardize the credentialing process.

Our Provider Education Series provides additional information.

Credentialing Forms

AzAHP Practitioner Data Form

Organization/Facility Application

Letter Templates

Lead Plan Acknowledgment

Initial Approval Letter

Approval Letter Amendment

Renewal Approval Letter

Notice Templates

Approval Notice

Denial Notice

Deficiency Notice

Contact Us

Pat Seabert, AzAHP’s Credentialing manager, would be happy to answer any of your questions or concerns. Please click on the button to get in contact with her.