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How does Prior Authorization work? The Prior Authorization Process Flow. How Long Do Prior Authorizations Take. Step 1: Check client eligibility. Step 2: Determine if a code or service requires Prior Authorization. Step 3: Find and complete forms. Step 4: Submit a PA request. Step 5: Check the status of an authorization.
Medicare: 1-800-MEDICARE (1-800-633-4227); TTY users: 1-877-486-2048; Visit medicare.gov. Social Security Administration:1-800-772-1213; TTY users: 1-800-325-0778; Visit socialsecurity.gov. Alabama Medicaid Agency:1-800-362-1504; Visit medicaid.alabama.gov.
Or, call 888-397-8129.
More than a million Alabamians each year qualify for full or partial Medicaid coverage. To qualify for Medicaid, applicants must meet income, age or other requirements; provide proof of income and other information, fill out forms correctly and turn in a completed application to the correct office or worker.
As of August 1, 2021, Alabama Medicaid no longer require PCP referrals to specialists. However, some provider offices may require a referral prior to rendering services to Alabama Medicaid recipients. In this case, the referring provider would need to comply with the rendering providers request.
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For help enrolling as a Medicaid provider, contact 1(888) 223-3630 or (334) 215-0111.
Federal regulations permit the Alabama Medicaid Agency to require prior authorization (PA) for any service where it is anticipated or known that the service could either be abused by providers or recipients, or easily result in excessive, uncontrollable Medicaid costs.
For questions related to prior authorization or overrides, contact KEPRO at 1-800-748-0130.

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