Billing Update from - Alabama Medicaid

All claims not requiring attachments (such as third party insurance denials) or an administrative review override must be submitted electronically.

Claims may be submitted electronically through:
• Medicaid’s Interactive Web Portal - Allows claims to be submitted in an online real time environment. This service is available at no charge to providers.
• Provider Electronic Solutions (PES) software - Allows claims to be submitted in batch mode for processing. This service is available at no charge to providers.
• Private software vendor - This service would involve a fee determined by the selected vendor.

In addition, Medicaid recipient eligibility must also be checked electronically as of March 1.

Electronic options for verifying eligibility:
• Medicaid’s Interactive Web Portal - Allows providers to check eligibility in an online real time environment. This service is available at no charge to providers.
• Provider Electronic Solutions (PES) software - Allows eligibility verification to be submitted in batch mode. This service is available at no charge to providers.
• Automated Voice Response System (AVRS) - Allows providers to check eligibility by telephone by dialing (800) 727-7848 (in-state) or (334) 215-0111 Option 5 (out-of-state). This service is available at no charge to providers.
• Private vendor - This service would involve a fee determined by the selected vendor.

Medicaid officials expect these changes to save the program more than $2 million by the end of FY 2011. 

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