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  • Provider Letter Of Intent - Ahcccs - Azahcccs

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The following information is provided as early notification for Offerors benefit. However, complete instructions regarding this Letter of Intent will be provided when the RFP is released. Only instructions.

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Income information is first collected from the Federal and State Data Services Hubs, if available, and compared to the income reported by the customer. When the customer reports income that is over the income limits for AHCCCS Medical Assistance (MA), it is reasonably compatible. No further proof is needed.

The member does not require a referral from the PCP to see a behavioral health medical provider. Members who are AHCCCS eligible and are also American Indian may access behavioral health services through the Tribal Regional Behavioral Health Authority (TRBHA) or Indian Health Service Facilities.

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.

Income Limits Household SizeGross Monthly Income Limit Effective 02/01/20231$1,6162$2,1863$2,7564$3,5252 more rows

7 calendar days from the date a complete application is received by AHCCCS.

Contact Us For Online Provider Enrollment/Application Payment Questions: Call: Maricopa County: 602-417-4254. Statewide: 1-888-827-4420. Write: AHCCCS Provider Enrollment Fee. 701 E. Jefferson, MD 5400. Phoenix, AZ 85034.

Eligibility – status of pending application, determination results, Processing Period If the customer is applying for:Then the processing period is...All other programs45 calendar days from the application date5 more rows

Phone Verifications: Maricopa County: 602-417-7200. Outside of Maricopa County, within Arizona: 1-800-331-5090.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232