Important provider forms
*** Important notice *** The ERA and EFT enrollment process has changed.
Need help? For questions regarding the forms or to check on enrollment status, please contact Provider Relations at 602-263-3000.
You can also send us a message via our website using the Contact Us form.
Whether you need to file a claim, inform us of a change of address or request prior authorization for a treatment, filling out the necessary forms will help us respond to your needs quickly and efficiently. Just click on the appropriate form name below to get started
AzAHP Non-Delegated Roster (Please scroll to the bottom of the AzAHP web page to access this roster.)
Mercy Care Provider Financial Guide (Document)