Sep 30, 2010 | Medical billing basics
Claims ProcessingHP verifies that the claim contains all of the information necessary for processing.The claim is processed using both clerical and automated procedures.First, the system performs validation edits to ensure the claim is filled out correctlyand contains...
Sep 30, 2010 | Medical billing basics
Identifying Services Requiring Prior Authorization The Alabama Medicaid Agency is responsible for identifying services that require prior approval. Prior authorization is generally limited to specified nonemergency services. The following criteria may further limit or...
Sep 30, 2010 | Medical billing basics
Alabama Recipient Aid Categories There are many valid recipient aid categories. Below is a listing of aid categories that indicate restrictions. Recipients with aid categories not identified in the following lists receive full Medicaid benefits. Partial Coverage The...
Sep 30, 2010 | Medical billing basics
Confirming Eligibility Whenever possible, providers should verify eligibility prior to providing service. To verify eligibility, providers should perform the following: Step 1 Request to see the recipient’s plastic card, or a copy of the eligibility notification...
Sep 30, 2010 | Medical billing basics
Most Alabama Medicaid recipients have permanent plastic Medicaid cards. These cards are white, blue, and green and resemble a credit card. Each card is embossed on the front (with raised lettering) with the following: • Recipient Identification (RID) number • Name •...
Sep 29, 2010 | Medical billing basics
What is the fastest way that I can obtain a National Provider Identifier (NPI) for me or my organization? The web-based NPI application process is the fastest and most efficient way for a health care provider to obtain an NPI. To apply, go to...
