Arizona Foundation for Medical Care

Enrollment
If you are interested in billing claims electronically to Arizona Foundation (AZFMC) please read below for complete instructions.

To submit directly to Arizona Foundation using SolAce EMC, please visit their website and fill out
the online form on their web page at:

    http://www.azfmc.com/ftp

Once you have filled out the form, a representative from AZ Foundation will contact your office with further instructions.

Required Information
We recommend that you have the following information ready before filling out your forms:

Your Submitter Information Software Vendor Information
Name Vendor Name – Ivertex
Address Contact – EDI Team
Phone and Fax Numbers Vendor Code – n/a
E-mail Address (if any) Phone – 602-439-2525
Contact Name (if other than name above) Fax – 602-439-0808
Provider PIN numbers for this payer Address – PO Box 86609
Phoenix, AZ 85080
Organization or Group PINs for this payer Software Name– SolAce EMC

E-mail – Support@Ivertex.com

Testing
Once you have received your Submitter ID and password from Arizona Foundation, please call the Ivertex Support Team and set an appointment for a Mailbox setup and Test Transmission.

Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.