Providers

Provider Enrollment

If you are a provider of medical services and wish to receive Medicaid reimbursement you must complete the required Medicaid provider enrollment application and enter into a written provider agreement with the Alabama Medicaid Agency. Federal requirements mandate providers to re-enrollment periodically with the Alabama Medicaid program. Providers will be notified when they are scheduled to re-enroll.

For further provider enrollment forms and information please click here.

Man and Woman with Doctor

Provider Billing

All reimbursements continue to be processed through Alabama Medicaid Agency.

Quality Improvement Program

The Quality Improvement program interfaces with providers regarding opportunities to improve effectiveness and efficiency through continuous monitoring of appropriate utilization of services and evidence based quality metrics. These programs are linked to customer service, member satisfaction, case management utilization, clinical risk management and delegate oversight areas.

The program encompasses all aspects of the physical health and LTSS delivery systems including:

  • Person-centered assessment
  • Care planning, with individualized goals
  • Medical and Home and Community-Based Services (HCBS) Case Management, including arranging appointments, disease management,  referrals to direct service providers (e.g., Personal Care, Homemaker Services, Adult Companion Services, Skilled/Unskilled Respite, Home Delivered Meals), and referrals to community resources
  • Transition support for enrolled individuals who have an institutional stay (hospital or SNF) while enrolled in the program (Transition of care/discharge planning)

Aging and Disability Resource Centers

Aging and Disability Resource Centers (ADRCs) are part of a national initiative put in place by the Administration for Community Living to provide access to information and assistance for older adults, individuals with disabilities and their caregivers.  The ADRC acts as a no wrong door for those needing assistance by providing benefits screening, education and options counseling on long term services and supports.  It is also an entry point for professionals, caregivers, and family members to seek resources and assistance on behalf of their clients, friends or family members. All callers are screened for assistance utilizing a universal screening tool that prevents the caller from having to give the information numerous times.  Referrals are made on behalf of the individual needing assistance and follow-up is provided for quality assurance. The ADRC will offer extended assistance to those who choose an advocate to assist with application for services and benefits.  ADSS strives to support individuals with the tools they need to make informed decisions and maintain their independence in the community of their choice.
For more information please click here.

Contact your local Area Agency on Aging (AAA) and Aging & Disability Resource Center (ADRC) at 1-800-AGE-LINE (1-800-243-5463)

Agency Locations

Agency Phone Address Counties Served
Northwest Alabama Council of Local Government 256-389-0590 256-389-0500 103 Student Drive
Muscle Shoals, AL 35661
Colbert, Franklin, Lauderdale, Marion, Winston
West Alabama Regional Commission 205-333-2990 4200 Highway 69 North Suite 1
Northport, Al 35476
Bibb, Fayette, Greene, Hale, Lamar, Pickens, Tuscaloosa
Middle Alabama Area Agency on Aging 205-670-5770 866-570-2998 209 Cloverdale Circle
Alabaster, AL 35007
Blount, Chilton, Shelby, St. Clair, Walker
Regional Planning Commission of Greater Birmingham 205-623-3551 2 20th Street North, Suite 1200
Birmingham, AL 35203
Jefferson
East Alabama Regional Planning and Development Commission 256-237-6741 Quintard Tower, Suite 300
1130 Quintard Avenue
Anniston, AL 36201
Calhoun, Chambers, Cherokee, Clay, Cleburne, Coosa, Etowah, Randolph, Talladega, Tallapoosa
South Central Alabama Development Commission 334-244-6903  5900 Carmichael Place
Montgomery, AL 36117
Bullock, Butler, Crenshaw, Lowndes, Macon, Pike
Alabama Tombigbee Regional Commission 877-777-4234 334-682-4234 107 Broad St.
Camden, AL 36726
Choctaw, Clarke, Conecuh, Dallas, Morengo, Monroe, Perry, Sumter, Washington, Wilcox
Southern Alabama Regional Council on Aging 800-239-3507 334-793-6843 1075 S. Brannon Stand Road
Dothan, AL 36305
Barbour, Coffee, Covington, Dale, Geneva, Henry, Houston
South Alabama Regional Planning Commission 800-243-5463 251-433-6541 110 Beaureguard St., Suite 207
Mobile, AL 36602
Baldwin, Escambia, Mobile
Central Alabama Aging Consortium 334-240-4680 818 Perry St.
Montgomery, AL 36104
Autauga, Elmore, Montgomery
Lee-Russell Council of Governments 334-749-5264 334-528-9213 2207 Gateway Dr.
Opelika, AL 36801
Lee, Russell
North Central Alabama Regional Council of Governments 256-355-4515 or 800-682-8604 216 Jackson St SE
Decatur, AL 35601
Cullman, Lawrence, Morgan
Top of Alabama Regional Council of Governments 256-830-0818 7037 Old Madison Pike Suite 450
Huntsville, AL 35806
DeKalb, Jackson, Limestone, Madison, Marshall

Non-Emergency Transportation

Non-Emergency Transportation (NET) will be provided to those Medicaid recipients who are being transported to an appointment for a Medicaid covered service. The appropriate mode of transportation should be based on the mobility impairments and special needs of the recipient. Further information regarding NET can be found here.

Nursing Facilities

Approximately three of every four nursing home patients in Alabama are covered by the Alabama Medicaid Agency. In order to qualify for nursing home care, patients must meet medical, financial and other requirements. A Long Term Care Ombudsman program is available to assist patients and families in resolving problems or concerns with a particular nursing facility. A list of nursing facilities located throughout Alabama can be found here.

Critical Incidents

Home and Community Based Setting (Waivers)

All Medicaid approved providers who provide home and community-based services in Medicaid recipient's home shall report incidents of abuse, neglect, and exploitation immediately to the Department of Human Resources, or law enforcement as required by the Alabama Adult Protective Services Act of 1976.

Other incidents such as falls must be reported within 24 hours to ASN or the members Case Manager (or supervisor) either verbally or electronically (email).Critical incidents can also be reported verbally to the Support Center by contacting the toll free service line at 1-855-288-7755. The Support Center will identify the member's assigned Case Manager and warm transfer the call to the appropriate Case Manager or Case Manager Supervisor to begin documentation of the incident.

If you would like to visit an agency in person, please find the nearest Area Agency on Aging location to you. Call 1-800-AGELINE (1-800-243-5463) to reach the Area Agency on Aging and Aging and Disability Resource Center that serves your county or visit http://www.alabamaageline.gov/area-agency.html for further contact information.

Nursing Facilities

All Nursing Facilities (NF) must ensure that all alleged violations and known or witnessed incidents, such as mistreatment, neglect, or abuse (including injuries of unknown source) and misappropriation of resident property, are reported within 24 hours to the administrator of the facility and to the Alabama Department of Public Health, in accordance with State law through the ADPH Incident Reporting System. NFs must also report any reasonable suspicion of a crime committed against a resident of that facility. Those reports must be submitted to at least one law enforcement agency (with jurisdiction where the facility is located) and the Alabama Department of Public Health within 2 hours of occurrence if the suspected incident causes serious bodily injury.

NFs must investigate these allegations and report the results of the investigation within 5 days to the administrator of the facility and The Alabama Department of Health, and if the alleged violation is verified, appropriate corrective action must be taken.