PDF
Word
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.
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.
