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PrescriberPatient Enrollment FormMS AcariaHealth

PrescriberPatient Enrollment FormMS AcariaHealth

Use a PrescriberPatient Enrollment FormMS AcariaHealth template to make your document workflow more streamlined.

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Video instructions and help with filling out and completing PrescriberPatient Enrollment FormMS AcariaHealth

Find a suitable template on the Internet. Read all the field labels carefully. Start filling out the blanks according to the instructions:

Instructions and help about PrescriberPatient Enrollment FormMS AcariaHealth

In this video tutorial, you will see the enrollment process for a facility, agency, or organization (or FAOs) that would like to register with AHCCCS. The enrollment process for FAOs includes all of the steps that are required for other types of providers such as sole proprietors, group practices, and contractors. For your reference, there are also procedural documents for all enrollment types available on the APEP website. If you are interested in learning about specific steps in the process, hover your mouse over your screen, and click the bookmark for the step you are interested in. Begin your new enrollment by selecting the New Enrollment button on the APEP homepage, then select your enrollment type. In this example FAO is chosen. Step 1 of enrollment is to provide your basic information. All fields marked with an asterisk are required. Note that if you are an employee of a facility agency, or provider organization and you do not have an EIN, your employer must have an application

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