Oct 12, 2010 | Medical billing basics
Electronic PA Requests Requiring Attachments If attachments are required for PA review the attachments must be sent to HP to be scanned into the system. Do not fax this information to the Alabama Medicaid Agency unless a request is made for specific information by the...
Oct 12, 2010 | Medical billing basics
Submitting a Prior Authorization Request To receive approval for a PA request, you must submit a complete request using one of the approved submission forms. This section describes how to submit online and paper PA requests, and includes the following sections: •...
Oct 11, 2010 | Medical billing basics
Third Party Liability Providers should verify whether a Medicaid recipient has other insurance prior to submitting a claim to Medicaid. Because federal Medicaid regulations require that any resources currently available to a recipient are to be considered in...
Oct 11, 2010 | Medical billing basics
Benefit Limits The Alabama Medicaid Agency establishes annual benefit limits on certain covered services. Certain services are excluded, such as services rendered as a result of an Early Periodic Screening, Diagnosis, and Treatment (EPSDT) screening. The EPSDT program...
Oct 11, 2010 | Medical billing basics
What qualifications must be met for services to be considered “incident to” services? Services that qualify as an “incident to:” • must be part of your patient’s normal course of treatment; during which • a physician personally performed an initial service; and •...
Oct 9, 2010 | Medical billing basics
Medicaid’s Medicare Advantage Managed Care Plan There are currently four companies who contract with the Alabama Medicaid Agency and offer Medicare Advantage coverage in Alabama – United HealthCare’s Medicare Complete, Viva Health’s VIVA Medicare Plus and Blue...
