Provider Enrollment out-Of-State - Arizona

Provider Enrollment out-Of-State - Arizona

Provider Enrollment out-Of-State is a legal document that was released by the Arizona Health Care Cost Containment System - a government authority operating within Arizona.

FAQ

Q: What is Provider Enrollment Out-of-State in Arizona?
A: Provider Enrollment Out-of-State in Arizona is the process of obtaining approval to provide healthcare services in Arizona when you are located outside of the state.

Q: Who needs to go through Provider Enrollment Out-of-State in Arizona?
A: Healthcare providers who are located outside of Arizona but want to offer their services in the state need to go through Provider Enrollment Out-of-State.

Q: What documents do I need for Provider Enrollment Out-of-State in Arizona?
A: The required documents for Provider Enrollment Out-of-State in Arizona may include your professional license, liability insurance, and an executed Out-of-State Participation Agreement.

Q: How long does it take to get approved for Provider Enrollment Out-of-State in Arizona?
A: The approval time for Provider Enrollment Out-of-State in Arizona may vary, but it typically takes several weeks to process the application.

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Form Details:

  • The latest edition currently provided by the Arizona Health Care Cost Containment System;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Arizona Health Care Cost Containment System.

Download Provider Enrollment out-Of-State - Arizona

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