Obtain a National Provider Identifier (NPI) Number The federal government requires that providers who administer medical and other health services should obtain a NPI number a unique 10-digit identification number for covered health care providers. The latest enrollment data shows 53.3% Arizonans covered by . Need help with applying? Download the FA-001-FF application by clicking. }Q]G];/NOI%=MA|F3\% Submit all supporting documentation - In addition to a complete application, each provider is required to submit all applicable supporting documentation at the time of submission to avoid processing . You can also contact Community Assistors which help people complete and submit their Medical Assistance application. (e.g., paper provider enrollment application, etc. Call or visit your local county social services office and ask for a Medi-Cal application. Apply personally at a local FAA office, at the Department of Economic Security (DES) office, at the hospital, or at certain clinics. 2226 0 obj <>/Filter/FlateDecode/ID[<7E13598C50AB214791283D6D87E75447>]/Index[2197 50]/Info 2196 0 R/Length 134/Prev 724933/Root 2198 0 R/Size 2247/Type/XRef/W[1 3 1]>>stream Applicants will receive a medical assistance letter that contains the official start date. Proof of mortgage or rent, as well as utility bills for the past months. Individuals must meet certain income and other requirements to obtain services. You must keep proof of your income and child care expenses over the six-month period and give it to DES at your review. Give the manager or owner of the restaurant this flyer about the Restaurant Meals Program for merchants. If your application is approved, you can choose which AHCCCS health plan you would like to cover your benefits. This website and its contents are for informational purposes only. Again, if you need assistance determining your qualification status, consult Valleywise Health Eligibility Specialists by calling (602) 344-2550 or visiting www.valleywisehealth.org/patients. Apply in Person at your county office or Fill out paper application form and mail to your county office. The federal Public Health Emergency will be ending soon, and AHCCCS will be returning to regular renewals April 1, 2023. Health-e-Arizona Plus is an on-line application for Arizona Residents. About 65% of Valleywise patients utilize the Arizona Health Care Cost Containment System (written AHCCCS and pronounced access). For more information visit the National Plan and Provider Enumeration System (NPPES) webpage at https://nppes.cms.hhs.gov or contact the NPI Enumerator at 1-800-465-3203 or TTY 1-800-692-2326. Please do not turn in original documents. Learn how to report a change to your existing Nutrition Assistance case. Phone: 602-417-4000 The Cash Assistance program provides temporary cash benefits and supportive services to the neediest of Arizona's children and their families. AHCCCS is available to: Children birth to 1 year with family income up to 147% of the federal poverty level. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. Find out what programs are available and where to go for assistance. Applicants are assigned a case manager to coordinate their care. Our broad network of providers offers services and supports for members with: Physical, general mental health and substance use concerns (Complete Care) Children and youth in the foster care system . Your insurance company can't charge you more for getting emergency room services at an out-of-network hospital. We also use third-party cookies that help us analyze and understand how you use this website. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) ), APEP Training (videos, documents, training sessions), Provider Enrollment Application & Provider Participation Agreement, Phone: 602-417-4000 A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. Proof that your employment ended and last date paid. 1. You are required to report any changes that may affect your Medical Assistance eligibility. Once your application is submitted, your food stamp office will send you a notice regarding your eligibility. Submit all supporting documentation In addition to a complete application, each provider is required to submit all applicable supporting documentation at the time of submission to avoid processing delays. Provider Assistance Unit: (602) 417-7670 option 5. These cookies do not store any personal information. Learn more about how AHCCCS is planning for the end of the Public Health Emergency. Providers should review the application and follow the instructions for completing the application to enroll their existing AHCCCS provider ID. If your profession requires a certification or licensure in the State of Arizona, these qualifications must be active at the time of enrollment and throughout the duration of the active status of the provider enrollment AHCCCS ID. If you are approved for emergency services only, you may receive medical services from any provider (doctor, hospital, etc.) endstream endobj startxref By helping families fight food insecurity and meet one of their fundamental needs, they can focus on overcoming barriers to self-sufficiency. If you have an AHCCCS Medical Assistance/MA (Medicaid) case, keep your information up to date so you can receive the latest information. Getting emergency care. No, if you or your household meets one or more of the conditions listed on the webpage, your EBT card has been enabled to use at participating restaurants. If you want more information about the doctors, specialists or hospitals that work with a health plan that serves your county, call the number listed . You will receive a letter indicating whether you have mandatory co-payments. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, Change Report for Nutrition, Cash, and Medical Assistance Benefits, Publications for Nutrition, Cash, and Medical Assistance Benefits, Work Requirements for Able-Bodied Adults Without Dependents, The Emergency Food Assistance Program (TEFAP), Senior Farmers Markets Nutrition Program (SFMNP), WIC Farmers Markets Nutrition Program (FMNP), Cash and Nutrition Assistance Policy Manual, USDA Programs Nondiscrimination Statements, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), flyer about the Restaurant Meals Program for merchants, Restaurant Meals Program Memorandum of Understanding (MOU), USDA Food and Nutrition Service authorized Arizona to participate in the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot, Women, Infants, and Children (WIC) Farmers Market Nutrition Program, Equal Opportunity and Reasonable Modification, Is homeless and does not have a fixed or regular nighttime residence. 7500 Security Boulevard, Baltimore, MD 21244. For AHCCCS Medical Assistance: If you do not give us your immigration status information, you may only be able to get emergency medical services. This video is available in American Sign Language. I am a restaurant that is interested in participating in the Restaurant Meals Program. The 'start date' will show on the Medical Assistance decision letter for each person who applied. who meet all requirements for Title XIX eligibility as specified in the State Plan except for citizenship. 1. As announced by Governor Ducey, the USDA Food and Nutrition Service authorized Arizona to participate in the Supplemental Nutrition Assistance Program (SNAP) Online Purchasing Pilot. This care may be subject to a deductible, for example, or a hospital may have particular rules in place. Apply in Person at your county office or Fill out paper application form and mail to your county office. The Medicaid program in Arizona is called the Arizona Health Care Cost Containment System . Also, many SNAP Community Partners are also Community Assistors that can help you apply for Medical Assistance. All legal service programs in Arizona differ, and their criteria for accepting cases vary as well. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. Nutrition Assistance (formerly the Food Stamp Program) is Arizona's program for the Food and Nutrition Service (FNS) Supplemental Nutrition Assistance Program (SNAP). Arizonas cash assistance program. Last Updated: February 24, 2021 at 3:23 am. Let us know if you need assistance in getting the necessary information. Name and contact information of neighbor or landlord. Health Insurance Marketplace is a registered trademark of the Department of Health and Human Services. The software has a versatile toolbar that will enable you to edit PDF documents. No, participating restaurants are listed on the webpage and updated quarterly. You should review your receipts before leaving the restaurant. Fee-for-Service Fee Schedules, Contact Us BenefitsApplication.com is not a government website or a government agency. Apply for Medical Assistance Online. Thank you for your interest in becoming a provider in the AHCCCS program. You must also be under the income limit, which varies depending on your age and size of your household. The process for requesting a reasonable modification can be found at, Arizona Adult Protective Services Action Plan, World Elder Abuse Awareness Day Conference, Senior Community Service Employment Program, Workforce Innovation and Opportunity Act (WIOA), AHCCCS Health Insurance Frequently Asked Questions, Equal Opportunity and Reasonable Modification, Your family received AHCCCS Health Insurance benefits in Arizona in three of the last six months; AND, The person working is the parent or other relative caring for a minor child in the home. Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. 2246 0 obj <>stream Apply by mail: Download and print a paper application. Retailers who are interested in online purchasing for SNAP EBT must meet USDA Food and Nutrition Service (FNS) requirements and obtain authorization to participate. The statement must be made by a non-relative who doesnt live with you. Immediate free, confidential help is available. For additional documents, brochures and pamphlets related to the Medical Assistance program, please visit our Document Center. d|p3ft7k[L[31\~Z(C]x2pl By helping families fight food insecurity and meet one of their . You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). 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