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Arizona Loan Repayment Program

Loan Repayment Contracts – Repayment

Loan repayments are disbursed to the provider’s lender(s) quarterly only upon receipt of the Service Verification Form and Encounter Report Form submitted within 10 business days from the end of each contract quarter. A provider who has less than a quarter of service completed must still submit the required Service and Encounter Forms by the due date. Payment for those services will be pro-rated accordingly.

Prior to making loan repayment, ADHS will verify that a fully completed, signed and notarized Service Verification and Encounter Report Forms were submitted.

Following receipt of the required forms, ADHS will authorize the claim and , ADHS will make payments directly to the provider’s qualifying lending institution(s).. A delay in the provider's submission of the Service Verification and Encounter Report Forms will result in the delay in lender payment. Failure to submit the required forms will result to no loan repayment to the lender.

Since there will be a three month period of time before the first payment is made to the lender(s), the recipient must coordinate with each lender to make necessary adjustments to the payment schedule for each loan so that quarterly payments will not result in default.

NOTE: The recipient remains responsible for timely repayment of the loan or loans.