Join Our Network
Thank you for your interest and participation in Banner – University Health Plan’s (B – UHP) Network. We are committed to maximizing the member and provider experience in meaningful ways.
Please use the guide below to assist your practice or care organization to become a participating provider and provide guidance during and after the contracting process.
Providers seeking a contract should submit a Provider Interest Form and AzAHP forms (located below), which should be attached to the Provider Interest Form. The Provider Interest Form located at: https://www.bannerhealthnetwork.com/BHNProviderInterest?source=BHN.
If you have questions or need to provide additional supporting documentation, please email BPAProviderContracting@BannerHealth.com. Please allow 120 days before requesting status.
AzAHP Facility and Practitioner Forms
Complete AzAHP forms below.
*Submit forms with Provider Interest Form only after AHCCCS Registration is completed.
AzAHP Group Roster Form (use for 10 or more practitioners under one TIN)
*Important Notice: Effective 10/01/2022, requests for updates must be submitted on the most current AzAHP Practitioner / Practice Change Form and are required to be sent to BUHPDataTeam@bannerhealth.com.
*Disclaimer: Please specify the action for the request. Include the documents requested on page 1 of the AzAHP form. Without the necessary documents, the processing will be delayed.
Behavioral Health Providers
Behavioral Health providers should include a summary description of programs, including target populations and age categories, specific models of care/therapies used, along with frequency of programming treatment and complete Exhibit E for each location. See link to instructions and form below.
Contract-related Inquiries and Contract Status:
Please include the name of your organization and tax identification number in your email.
Please submit requests to: BUHPDataTeam@bannerhealth.com
Please submit an updated facility and provider roster with current AHCCCS-registered locations and providers with their NPI(s) and TIN(s).
Providers with an existing contract requesting to add a new practitioner to their contract should submit an AzAHP form.
All practitioners must be registered with CAQH. The primary contact information in CAQH must be current to avoid credentialing delays. Practitioners must also re-attest to the validity of their information quarterly.
Tips and FAQs
- Register with AHCCCS Administration as a provider for AHCCCS and maintain it throughout the term of this agreement. B – UHP is not responsible for payment to non-registered providers. Follow all terms of your contract and adhere to B – UHP’s Provider Manual and Behavioral Health Manual, when applicable. The Provider Manuals are located at https://www.banneruhp.com.
- Notify B – UHP Provider Contracting at least 30 days before the effective date of any changes in tax identification number, services, the organization’s legal name change, or any requested changes to your contract.
- B – UHP will return the executed contract once the signed contract is completely loaded in B – UHP systems.
- Please note that submission of an AzAHP form does not guarantee that a provider contract will be offered to your practice or organization.
Q. How do I know if I am currently contracted with Banner – University Health Plan (B – UHP)?
A. Contracted providers are given a copy of their contract after completion of credentialing and loading into B – UHP systems. If you need a copy of your contract, please email UAHNContractingMailbox@bannerhealth.com. Include the name of your organization and tax identification number in your email.
Q. How long does the B – UHP credentialing process take?
A. Once a complete clean AzAHP form is received, the credentialing process and loading into systems can take up to 60 days.