Join our network
Providers must complete the following steps to be eligible to participate in our network:
- Credentialing application must be submitted correctly and completely.
- Providers must be fully credentialed by Mercy Maricopa.
- New providers will be mailed a Participating Health Provider Agreement (contract). Providers joining an existing group must complete the applicable contract documents in order to be added to the existing contract.
- Providers must sign and return all contract documents.
- Upon completion of credentialing and full execution of contract documents, the provider will receive notice from Mercy Maricopa network development department with the effective date of participation, along with the fully executed contract (if it is a new contract).
Providers should refrain from scheduling and seeing Mercy Maricopa members until notified of the participation effective date.
Should you have any questions regarding the process, please call your Provider Relations representative.
All providers who are interested in contracting with Mercy Maricopa must fax a Letter of Interest (LOI) to Mercy Maricopa at 860-975-0841.
The LOI should be on the provider’s letterhead and must include the following information:
- AHCCCS ID number
- Medicare ID number (if applicable)
- Geographic location
- Provider specialty and services/facility
Please submit the following forms with your LOI:
- W-9 Form
- AzAHP Facility Application
- AzAHP Practitioner Credentialing Form
- AzAHP Organizational Credentialing Form
We are committed to providing quality health care services to our members. And our credentialing and contracting processes help us achieve that goal.