www.MercyCareAZ.org
August 16, 2021
New AzAHP Credentialing Forms for 2021

Applies to: Mercy Care Complete Care, Mercy Care DD, Mercy Care Long Term Care, Mercy Care RBHA, Mercy Care DCS-CHP, and Mercy Care Advantage
The AzAHP Credentialing Forms have been updated for 2021 and added to our website as well as our Provider Manual. Please note that the organization and facility credentialing forms have been combined. The new forms are as follows:


Use of these forms is mandatory and 2020 forms will not be accepted on or after October 1, 2021.

As always, don't hesitate to contact your Mercy Care Network Management Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

Thanks for all you do!
www.MercyCareAZ.org