Providers must notify the Alabama Medicaid’s Agency when releasing information (claims, charges and medical records) regarding a patient’s care. This ensures that Medicaid is informed when the recipient intends to use the information in order to obtain third party funds from an insurance company or through a lawsuit that should be paid to the provider or to Medicaid.
Providers are NOT required to notify Medicaid if records are requested under the following circumstances:
- Requests from Medicaid or its fiscal agent.
- Requests from federal or other state agencies
- Requests by insurance companies to process an application for insurance, to pay life insurance benefits, or to pay a loan
- Requests from other providers for medical information needed in the coordination of a patient's treatment.
- Requests from insurance companies for information pertaining to a claim filed by the provider in accordance with Medicaid regulations and for which an assignment of benefits to the provider was furnished to the insurance company.
For other exceptions, see Chapter 20 of the Administrative Code.
NOTE: Health Management Systems (HMS) is under contract with Alabama Medicaid to process the "Request for Medical Records" and perform the evaluation and case tracking functions of all casualty and litigation cases. Medical record request forms are to be faxed to HMS at 866-274-5974. To contact HMS by phone regarding a medical record request or for information related to a casualty or litigation case, you may reach HMS at 877-252-8949.