Notification of Practitioner Rights

Arizona Foundation follows NCQA Credentialing Standards during the credentialing and recredentialing process of new and existing practitioners.

Arizona Foundation would like you to be aware that at any time during the credentialing process you have the right to:

  • Review information submitted to support your credentialing application. - To review information submitted to support your credentialing application, you must submit a written request via email or US mail (see address below) no later than 30 days of the original Credentialing Committee decision letter and address the request to the Credentialing Coordinator.
  • Correct erroneous information. - To correct erroneous information, you must submit a written request via email or US mail (see address below) no later than 30 days of the original Credentialing Committee decision letter and address the request to the Credentialing Coordinator.
  • Receive the status of your credentialing or recredentialing application, upon request. - Should you choose to inquire about the status of your application, you may do so at any time prior to the completion of the credentialing process either verbally or in writing.  Please direct your request to the Credentialing Coordinator.  The Credentialing Coordinator will respond to your request as soon as possible but no later than 4 calendar days of your request.  
  • Be notified if information collected during the credentialing/recredentialing process varies substantially from information that was collected by the practitioner (e.g., actions on a license, malpractice claims history, board certification). If this situation arises, Arizona Foundation will mail a notification letter to the practitioner indicating such.  
  • Review information obtained from outside sources (e.g., malpractice insurance carriers, state licensing boards) to support their credentialing application. - To review information submitted to support your credentialing application, you must submit a written request via email or US mail (see address below) no later than 30 days of the original Credentialing Committee decision letter and address the request to the Credentialing Coordinator. Arizona Foundation will not make available, references, recommendations and peer protected information.

Should you wish to exercise these rights, please contact Arizona Foundation Provider Relations at 602-252-4042 or by email at providerrelations@azfmc.com.  All other written requests should be mailed to:

Arizona Foundation for Medical Care
2700 N. Central Ave, Ste. 810
Phoenix, AZ 85004
Attention: Credentialing Coordinator