We recognize the importance of checking eligibility before providing services, however, there are many ways to access eligibility information other than calling Member Services. Accessing the below methods will alleviate unnecessary hold times on the phone and can be done in real time. Using these alternative options allows you to get eligibility information when it’s needed and also outside of our normal customer service hours. We strongly encourage using the alternative options provided to assist in your business operations and to allow our customer service representatives to be available to assist with other types of questions or issues you may have.
The most convenient way to receive eligibility information is through:
Other convenient methods:
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MediFax: MediFax is an electronic product available through AHCCCS that stores key member information. It is used to verify MC member eligibility for pharmacy, dental, transportation and specialty care. In Maricopa County only, providers can request faxed documentation through Medifax EDI: 800-444-4336.
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AHCCCS Interactive Voice Response (IVR): To use, dial 602-417-7200. For providers outside of Maricopa County only please dial 1-800-331-5090.
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Monthly Roster: Monthly rosters are found on our secure website portal. Contact your Network Management Specialist/Consultant for more information. Please note that rosters are only updated once a month.
All providers, regardless of contract status must verify a member’s enrollment status prior to the delivery of non-emergent, covered services. The Member PCP assignment is important and should reflect the correct assignment. However a claim will not deny for the provider not being the member's PCP; it will be considered for payment. We recommend that if the member is being aligned to your practice going forward that you make that change on the first business day following the appointment by e-mailing:
Thanks for all you do!
