Medicare Blog

how does a nurse become a medicare provider in arizona

by Prof. Ali Hand Published 2 years ago Updated 1 year ago
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Apply with the Arizona Board of Nursing to take the CNA examination. You must submit a completed application in black ink, proof of your caregiver training, and proof of your citizenship or legal right to work in the United States.

Full Answer

How do I get an advanced practice nurse certification in Arizona?

The advanced practice nurse will need to provide verification of current certification. Credentialing information is available from the Arizona State Board of Nursing. AZBN can be reached by email contact form or by telephone at 602-771-7800. To View Full U.S. Map Click Here.

How do I become a contracted provider for Arizona complete health?

Arizona Complete Health provides excellent medical and behavioral health services to our members through the help of our contracted provider agencies. To become a contracted provider: To Join our network fill out a Potential Provider Application. Please note that submission of an application is not a guarantee that you will receive a contract.

What are the requirements to become an APRN in Arizona?

Other population foci may be accepted if there are appropriate accrediting agencies and certification agencies. In order to be credentialed as an APRN, an individual must hold licensure as an RN, either in Arizona or in another nurse compact state.

What are the different types of nurses in Arizona?

Arizona recognizes four roles: Registered Nurse Practitioner (RNP), Certified Nurse Midwife, Clinical Nurse Specialist (CNS), and Certified Registered Nurse Anesthetist (CRNA).

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How long does it take to get a Medicare provider number?

Most Medicare provider number applications are taking up to 12 calendar days to process from the date we get your application. Some applications may take longer if they need to be assessed by the Department of Health.

How do I register as a Pecos provider?

0:146:13Medicare Provider Enrollment Through PECOS - YouTubeYouTubeStart of suggested clipEnd of suggested clipNumber if you do not already have an active NPI number you can register for one through the nationalMoreNumber if you do not already have an active NPI number you can register for one through the national plan and provider enumeration system or n Pez.

What does it mean to be credentialed with Medicare?

Credentialing is the process of approving a physician, agency or other medical provider as part of the Medicare supply chain.

What is Pecos Medicare requirement?

It is a database where physicians register with the Centers for Medicare and Medicare Services (CMS). CMS developed PECOS as a result of the Patient Protection and Affordable Care Act. The regulation requires all physicians who order or refer home healthcare services or supplies to be enrolled in Medicare.

How do I become a Pecos resident?

How to Complete Enrollment. Complete your enrollment online at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/index. Select “Internet-based PECOS” located in the left navigation menu to access instructions and a link to the online enrollment form.

How long does Pecos application take?

How long does it take? Depending on the type of enrollment record, you can expect it to take anywhere from 60-90 days for individual and new practice enrollment records(submitted through PECOS) and approximately 120 days for DMEPOS or part A (855s and 855a) enrollment applications.

What is the process of credentialing?

Credentialing is a formal process that utilizes an established series of guidelines to ensure that patients receive the highest level of care from healthcare professionals who have undergone the most stringent scrutiny regarding their ability to practice medicine.

What is Caqh and credentialing?

CAQH is an online data repository of credentialing data. Practitioners self report demographic, education and training, work history, malpractice history, and other relevant credentialing information for insurance companies to access.

Who performs the credentialing?

Many health care institutions and provider networks conduct their own credentialing, generally through a credentialing specialist or electronic service, with review by a credentialing committee. It may include granting and reviewing specific clinical privileges, and allied health staff membership.

What is Pecos and Nppes?

Accordingly, the Centers for Medicare & Medicaid Services (CMS) uses enrollment systems, including the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) and the National Plan & Provider Enumeration System (NPPES), to manage provider information and identifiers.

Who uses Pecos?

PECOS is Medicare's online provider enrollment management system. It is the national system CMS uses to register healthcare providers and suppliers for Medicare. It centralizes national data about Medicare providers and suppliers. PECOS launched in 2002.

Is Pecos ID same as Medicare number?

The following walk-thru explains how a user can find their Medicare ID number in PECOS. Medicare numbers are also known as the CCN, P-Tan, Oscar, Provider number, or Medicare ID.

How to become a nurse in Arizona?

In order to become a nurse in Arizona, you must be licensed through the Arizona State Board of Nursing. Nurses are either endorsed or licensed. Additionally, Arizona is a compact state, which means that a license from another compact state can be used in Arizona.

How old do you have to be to become a nurse midwife in Arizona?

Finally, Arizona also recognizes the Certified Nurse Midwife. In order to become certified, your education must be no more than five years old.

What are the different types of nurse practitioners?

There are four different categories you can choose from, namely, the CNM (Certified Nurse Midwife), the RNP (Registered Nurse Practitioner), the CNS (Clinical Nurse Specialist) and the CRNA (Certified Registered Nurse Anesthetist. The program must be certified by a national agency. The available options are: 1 The ANCC (American Nurses Credentialing Center), which recognizes Adult Nurse Practitioners, Acute Care Nurse Practitioner (ACNP), Gerontological Nurse Practitioner (GNP), Family Nurse Practitioner, Adult Psychiatric Mental Health Nurse Practitioner (PMHNP), Pediatric Nurse Practitioner PNP) and the Family Psychiatric Mental Health Nurse Practitioner (PMHNP). 2 The AANP (American Academy of Nurse Practitioners), which recognizes the Adult Nurse Practitioner and the Adult-Gerontology Primary Care NP. 3 The PNCB (Pediatric Nurse Certification Board, which recognizes acute and primary care pediatric nurse practitioners. 4 The NCC (National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties), which recognizes the Women’s Health Care Nurse Practitioner (WHNP) and the Neonatal Nurse Practitioner (NNP). 5 The AMCB (American Midwifery Certification Board), which recognizes the certified nurse midwife (CNM). 6 The AACN (American Association of Critical Care Nurses, which recognizes the pediatric critical care CNS, the adult critical care CNS and the neonatal critical care CNS. 7 The National Board on Certification and Recertification of Nurse Anesthetists (NBCRNA), which recognizes the Certified Registered Nurse Anesthetist (CRNA).

How to become a CRNA?

For CRNA, you must complete the Application for Certified Registered Nurse Anesthetist. Again, you must include all relevant documentation and you must prove you have completed hours of pharmacology or clinical drug management education. You must also apply to the DEA if you wish to have prescriptive authority for controlled substances.

What is the national accreditation agency for nurse practitioners?

Department for Education. The national accreditation agencies are: The American Nurses Credentialing Center. The American Academy of Nurse Practitioners.

How many clinical hours are required for a graduate nursing program?

Graduate programs must always include a minimum of 500 clinical practice hours. Additionally, they must include advanced pathophysiology, application of evidence to advanced practice, the advanced practice nursing role and advanced health assessment. If the graduate program includes 45 contact hours of clinical management ...

How long does it take to become a RN?

Become an RN through a bachelor’s degree, which takes around four years to complete and is much more advanced and in-depth than the associate’s option. STAGE 2. BECOME CERTIFIED BY PASSING THE NCLEX-PN OR THE NCLEX-RN EXAMINATION.

What is Arizona Complete Health?

Arizona Complete Health provides excellent medical and behavioral health services to our members through the help of our contracted provider agencies. To become a contracted provider:

How long does it take to get a contract from a potential provider?

Upon receipt of all required documentation, you will receive a contract or outreach within 14 days regarding next steps in the process.

What is a potential provider team member?

A Potential Provider team member will work with you to obtain all necessary documentation for credentialing and other contract load functions – for example, physician roster, etc. The timeline for the contracting process is highly dependent on the amount of time it takes to complete this step in addition to the accuracy of the documentation you provide.

What happens if a potential provider is approved by the committee?

Upon committee approval, the Potential Provider Team will contact you and request documents to complete you application. Timeline will be highly dependent on submission of documents

What happens if you are selected for a potential provider?

If selected, the Potential Provider Team will contact you and request information to complete your application.

How to contact Arizona State Board of Nursing?

Credentialing information is available from the Arizona State Board of Nursing. AZBN can be reached by email contact form or by telephone at 602-771-7800.

How many hours do you need to become a nurse practitioner?

A nurse practitioner or nurse midwife who seeks prescriptive privilege will need three semester hours or 45 contact hours of pharmacology. Coursework can take a variety of forms, including accredited conferences or self-study. However, it must be completed within the three-year period preceding application. The Board can accept an official sealed transcript or a copy of a continuing education certificate; if the certificate does not show the number of hours, the candidate should also include a program.

What is an APRN program?

An APRN program can be accepted if it was 1) offered by an appropriately accredited institution or 2) approved or recognized as qualifying in the jurisdiction in which it was located. In-state programs are reviewed according to criteria listed in R4-19-502. The Board has provided a list of approved APRN programs ...

Can an anesthetist be certified?

A nurse anesthetist can pursue certification by the National Board of Certification and Recertification for Nurse Anesthetists. The Board review certifying agencies in accordance with criteria found in R4-19-501. Approvals are subject to change.

Can a nurse practitioner be certified in Arizona?

Nurse practitioners, nurse anesthetists, and clinical nurse specialists who were credentialed in the more distant past may be certified without meeting Arizona’s current educational requirements. For nurse practitioners, the requirement for a degree at the master’s level or higher does not apply to some practitioners who were licensed before November 1, 2001; those who were licensed before this date are eligible for credentialing if the qualifying out-of-state credential is current or if it lapsed during the most recent six-month period (https://www.azbn.gov/faqs/licensure-certification/advanced-practice-faqs). Nurse practitioners who hold master’s degrees in health fields other than nursing may be eligible if the out-of-state license was issued by November 13, 2004.

Do you need to complete a nursing major in Arizona?

Prospective nurse practitioners and clinical nurse specialists must complete nursing majors at the graduate level ( Nurse Prac titioner programs in Arizona ). Prospective nurse anesthetists must complete CRNA programs. Board rule references programs accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs as acceptable, but notes that other accreditations may be found acceptable as well.

Does an APRN license expire?

APRN certifications and CRNA privileges expire at the same time that the RN license does. The advanced practice nurse will need to provide verification of current certification.

What is provider enrollment email?

Provider Enrollment has established an email address to send an email regarding a provider related enrollment question, policy or require troubleshooting an APEP issue. The email address is established to automatically assign a service ticket for provider enrollment to review, respond and take the appropriate action to resolve the question.

When did the AHCCCS portal start?

The new AHCCCS Provider Enrollment Portal (APEP) launched August 31, 2020, offering a secure web-based enrollment process and a streamlined provider enrollment process that allows a provider to electronically submit a new enrollment or modify an existing provider ID.

What is HSAG in Arizona?

HSAG, Arizona’s Medicare contracted Quality Improvement Organization, has added medication management resources to its website, hsag.com. As prescribers, you may be interested in integrating them into practice to reduce adverse drug reactions by improving medication safety practices for 3 high risk medication classes, anticoagulants, diabetic agents and opioids. The Quick Tips for Prescribers, one for each drug class can be viewed by clicking on the webpage link below and then opening the down arrow for the list of documents. They are meant to be printed double-sided to keep them at ‘one-page’.

How many hours of continuing education is required for a health professional?

The three hours of continuing medical education or accredited continuing education that is approved by the applicable health profession regulatory board shall be included as part of any continuing education requirements for that health professional.

What is HSAG medication management resource?

HSAG Medication Management Resources: Another tool you may be interested in is the Medication History Toolkit that was launched in November that was designed to improve practices related to obtaining a comprehensive and accurate medication history and a video on pharmacist integration to improve medication outcomes. The toolkit can be used for nurses who are the one’s doing the bulk of medication histories everywhere. The toolkit even includes a competency validation checklist.

Does Arizona require e-prescribing?

Specifically, when e-prescribing, prescribers must remember to apply the order to paper that includes security features as described below.

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