For provider information regarding COVID-19 vaccinations, 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
Facility Credentialing / Recredentialing Application
Organization Data Form
Practitioner Data Form
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.
