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Does Alabama Medicaid require prior authorization?

Prior Authorization (approval in advance) is required for many procedures, services or supplies, including transportation. Click here for information on obtaining an Emergency PA for medications. Below are the forms used for Prior Authorization. Prior Review and Authorization Request Note: a completed form is required.

How do I contact Alabama Medicaid EDI?

(800) 456-1242 (Nationwide Toll Free) Local: (334) 215-0111.

What is the phone number to apply for Medicaid in Alabama?

Apply online Call (800) 362-1504 (Toll-free) to find a location near you.

Does Alabama Medicaid have OTC benefits?

Brand preferred drugs, generics (some exceptions apply) and over-the-counter (OTC) drugs covered by Medicaid are available without prior approval. If a non-preferred drug is ordered, the practitioner will need to obtain prior authorization (PA).

How many prescriptions does Alabama Medicaid cover?

How many prescriptions can I get each month? Adult Medicaid recipients may get up to five total drugs (including up to four brand name drugs) per month. There are no limits on drugs for children.

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Who is the PBM for Alabama Medicaid?

Alabama Medicaid does not utilize a Pharmacy Benefits Management vendor. However, Alabama does utilize a clinical contractor to compile the clinical review packet for each PT meeting. All financial and supplemental rebate matters are coordinated by Alabama Medicaid staff.

What is the phone number for Medicaid provider relations in Alabama?

Provider Enrollment Contact Information: (888) 223-3630 (Nationwide Toll-Free) Hours (All times Central) - Monday - Friday 8 a.m. to 5 p.m.

Does Medicaid of Alabama accept paper claims?

Claims Submission Methods Claims filed on paper must be submitted on a CMS-1500 claim form. Instructions for paper claim submission can be found in Chapter 5 of the provider billing manual.

What is covered under Alabama Medicaid?

Medicaid patients get medical care from a variety of sources. Covered medical services include dental, eye and hearing care, lab and x-ray services as well as renal dialysis and transplant coverage.

What is the phone number for Medicaid prior authorization in Alabama?

Prior authorization and other forms are available below. For questions related to prior authorization or overrides, contact KEPRO at 1-800-748-0130.

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Who is the PBM for Alabama Medicaid?

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