Attention: Physicians
The Alabama Medicaid Agency has made changes to the sample referral form posted on the Alabama Medicaid website describing the “required fields.” Please click here for the link to the updated version and instructions for filling out the form.
Signatures accepted on referral forms: The following has been added to the April 2012 edition of Appendix A of the Alabama Medicaid Provider Manual:
Signature Requirement for Referrals: Effective May 16, 2012:
For hard copy referrals, the printed, typed, or stamped name of the primary care physician with an original signature of the physician or designee is required. Stamped or copied signatures will not be accepted. For electronic referrals, provider certification is made via standardized electronic signature protocol.
Additionally, effective April 1, 2012, for services that require physicians’ orders, all orders must be written according to practice guidelines and state/federal law and must include the date and signature of the provider, the service(s) ordered and the recipient’s name. The Patient 1st/EPSDT referral form may be considered the physician’s order as long as these guidelines are met. See the appropriate chapter of the April 2012 edition of the Alabama Medicaid Provider Manual for additional details regarding specific requirements for each program area.