Thank you for your interest in participating in Arizona Care Network (ACN)
Clinicians and other health care provider organizations participating in ACN agree to be accountable to one another for the quality, cost and overall care of patients covered under ACN’s value-based agreements with health care payers. This includes a focus on evidence-based medicine, patient-centered care and following clinical guidelines, quality assurance and improvement programs, and performance-based metrics as directed by Arizona Care Network’s physician-led Board of Managers.
Clinicians must be approved by the physician members of ACN’s Network Committee and sign a standard Participation Agreement to participate in ACN, a copy of which is available for review upon request. The Network Committee meets monthly on the 3rd Wednesday of each month. Complete applications received by the 2nd Friday of each month are typically reviewed at the Committee’s meeting that same month.
The Network Committee considers a variety of factors when reviewing clinicians for participation, including the following requirements and expectations:
Unrestricted license to practice in Arizona
Mid-levels supervised by a licensed physician of the same specialty
Eligible to participate in Federal health care programs
Board Certified or Board Eligible (as defined by ABMS Member Boards)
Currently credentialed and contracted with one or more ACN payer partners
Reputation within the community; professional medical practice relationships with other ACN providers
Commitment to coordinate care within ACN’s network of participating providers/facilities
For certain specialties, provisional or active privileges at an ACN contracted facility are required per the policy available here
Under the new policy effective 7/15/2017, providers in certain designated specialties who admit patients and/or perform procedures in hospital or outpatient facility settings are required to be credentialed and maintain privileges at an ACN contracted care setting to participate in ACN. To assist providers that must pursue privileges with an Aligned Facility to remain contracted with ACN, we have provided information on how to begin the medical staff application process for either an Abrazo Community Health Network or a Dignity Health Arizona hospital facility below.
Abrazo Community Health Network: Providers should download and submit the Abrazo Data Collection Form. Upon receipt, a link to an online pre-application will be sent to the provider..
Dignity Health – St. Joseph’s Hospital and Medical Center & St. Joseph’s Westgate Medical Center: Providers should download and follow the instructions in the SJHMC Initial Application Packet. To apply for privileges, providers must (1) complete and submit the information requested in this packet and (2) complete an initial East Valley CVO application by following the instructions available here.
Dignity Health – Chandler Regional Medical Center & Mercy Gilbert Medical Center: Providers should complete an initial East Valley CVO application by following the instructions available here.
Providers who have questions about this new participation requirement, would like guidance on your options and/or would like to discuss the applicability of this Policy to you as the July 15, 2017 notification date approaches, please contact your Provider Network Consultant or email firstname.lastname@example.org
Application Denial Appeal Option
Clinicians and other health care provider organizations who are not approved to participate in ACN are eligible to re-apply 12-months from the date the application was declined. Applicants also have the option to appeal the decision of the Board of Managers, as outlined below:
Within 30 days following date of denial notice, the provider must notify ACN by email (email@example.com) of the intent to appeal *
Provider may file a written appeal for initial consideration by the Network Committee, which should include information the Network Committee will take into consideration when evaluating the appeal. Additionally, in the written appeal, the Provider may request the opportunity to present directly to the Network Committee during a 15-minute slot at an upcoming Committee meeting, as scheduled.
The Network Committee will deliberate on the appeal and formally arrive upon a recommended action for consideration at the next quarterly Board of Managers’ meeting (recommendations to either approve the application -or- reaffirm the declined application require Board of Managers’ approval).
The Board of Managers’ decision on the appeal will be final.
If the application denial is upheld by the Board of Managers, the provider will remain eligible to re-apply 12 months following the original application denial.
* currently there are limited appeal options for certain denials, including concerns with the provider’s state license, Federal program exclusions, lack of Board Certification/Board Eligibility and/or privileges at an Aligned Facility.
If you exclusively serve pediatric patients and are interested in participating in Arizona Care Network, please visit Phoenix Children’s Care Network or email or call (602) 933-7226.