♦ AMPM 520, Attachment A, Enrollment Transition Information (ETI) Form

Do not include Personal Health Information (PHI) in your comments.

  • Please ensure to include the Policy Page Number relating to each comment.
  • You will receive acknowledgement that your comments have been received. AHCCCS cannot provide responses to individual comments.

Proposed Policy:

AMPM 520, Attachment A – Enrollment Transition Information (ETI) Form

Comment Deadline: July 23, 2017

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