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Provider Enrollment

Provider Enrollment Phone Numbers:
(888) 223-3630 (Nationwide Toll-Free)
(334) 215-0111

Hours: (all times Central)
Monday-Friday 8 a.m. to 5 p.m.

Supervisor: Jeff Kochik - (334) 215-4152 - Click to send e-mail

  • Forms for Provider Enrollment and Re-Enrollment
  • Electronic Provider Enrollment Application Portal
  • Provider Enrollment Web Portal Training Manual
  • Providers Required to Submit an Enrollment Fee
  • Rural Health Clinic Cost Report - Useful information to help new providers establish the rate for reimbursement

    ACA Primary Care Physician Attestation:
    The Primary Care Physician Rate Increase under The Affordable Care Act (ACA) ends December 31, 2014.

    Medicaid-enrolled primary care physicians who qualify for Primary Care Enhanced Physician Rates may continue to receive enhanced payments after the federal program ends on December 31, 2014.To qualify, eligible providers must accurately self-attest by filing required 2015 forms.

    You must self-attest and submit board certification proof to continue payments for 2015 Primary Care Enhanced Physician Rates (“Bump”).
    Complete a 2015 self-attestation form
    • Attach proof of board certification (WEB VERIFICATION), if applicable
    • Mail original self-attestation form to the address below:

                    HPES, PO Box 241685, Montgomery, Alabama 36124
    All information must be complete and easy to read. Please retain copy for your records.

    Qualification for the payment increase will end the earliest of either September 30, 2015 or the expiration date of the board certification. Therefore, physicians whose board certifications expire before September 30, 2015, must self-attest for the program; services provided during any lapses in time between board certification expiration and self-attestation will not be eligible for the rate increase. The physician must notify HPES within 10 days if the board certification is lost.”

    Payment for Primary Care Enhanced Physician Rates:
    • An eligible provider with 2015 self-attestation form on file at HPES by January 31,
      2015, will receive payment at the enhanced rates retroactive to January 1, 2015.

    Federal requirements mandate providers re-enroll periodically with the Alabama Medicaid program. Providers will be notified when they are scheduled to re-enroll.  Failure to re-enroll and provide appropriate documentation to complete enrollment will result in an end-date being placed on the provider file. Once a provider file has been closed for failure to timely re-enroll, providers will have to submit a new application for enrollment.

    The listing of providers selected to re-enroll for the current month is listed under
    Re-Enrollment Forms entitled
    "List of Providers Scheduled to Re-Enroll."

    Ordering, Prescribing and Referring Providers:
    Federal law requires all physicians and other practitioners who prescribe or order services for Medicaid recipients, or who refer Medicaid recipients to other providers, must be enrolled as a Medicaid provider. Claims will deny beginning January 1, 2013, if provider is not enrolled.