ALABAMA MEDICAID’S NEW MEDICAL AND QUALITY REVIEW SERVICES

Announcements

News Bulletin

  • COVID-19 Emergency Expiration Date Extended to December 31, 2022.  *Medicaid is now preparing for the end of the Covid-19 Public Health Emergency.* For more information, please visit www.alabama.medicaid.gov for more information. 
  • Hospice, Nursing Home, ICF/IID, PHEC and Swing Bed: Submit documentation via electronic upload process as per the instructions in the Provider Manual on the Alabama Medicaid Agency’s website (Chapter 18 for Hospice records and Chapter 26 for nursing facility records). The process for electronically uploading records is the same for the ICF/IID, PEC and Swing Bed records.    
  • Hospice Recipient Status Change (Form 165B) LTC Requests for Action (Form 161B) and Form 471s fax to (833) 536-2134 or (833) 536-2136.
  • Claims submission and processing questions, please call (855) 523-9170 to speak to Gainwell Provider Relations Representative.
  • When submitting additional documentation on a Prior Authorization request, the documentation MUST be submitted under "Reconsideration" status. Kepro will not be alerted that documentation has been uploaded unless this process is performed correctly. 
  • FOR QUESTIONS OR ISSUES regarding the documentation upload process, please call Gainwell's Provider Assistance Center at (800) 688-7989 or (334) 215-0111. Documentation cannot be viewed by Kepro staff unless properly uploaded.