Frequently Asked Questions

Any physician or dentist who is licensed in the State of Alabama may become a Medicaid provider. All providers must apply to provide services to Medicaid recipients. Some provider types have additional requirements that must be met in order to enroll as a Medicaid provider. All providers must not be disqualified or sanctioned due to fraud or abuse of the program.

Many providers find that applying online is convenient. The link to apply online and hard copy forms are available on the Agency's website under Contacts > Provider Contacts > Provider Enrollment and Forms.

To complete an application you will need to know or be able to obtain about the provider applicant all or some of the following information, depending on the type of enrollment you are completing: National Provider Identifier (NPI) Basic Business Office Data (i.e., address, phone, fax, email address, etc.) Specific Office Data (i.e., CLIA Certification, Name and SSN of employees/personnel, etc.) Specific Provider Data (i.e., CLIA Certification, SSN, Licensure Information, etc.) IRS Tax Identification Data Banking Information Group Identification Data (i.e., Name, NPI, Medicaid ID).

Contact the Gainwell Technologies Provider Enrollment unit at (888) 223-3630 (Nationwide Toll-Free) Monday - Friday between 8 a.m. to 5 p.m. Supervisor: Melissa Gill may be reached at (334) 215-4152 or by email at Melissa.Gill@gainwelltechnologies.com.

To participate in Alabama Medicaid Primary Care Enhanced Rates "Bump" Program, it will be necessary to complete a self-attestation form which is available on the Agency website under Resources > Forms Library > Provider Enrollment Forms. All fields on the self-attestation form must be completed correctly. For questions about how to fill out the form, please contact a Gainwell Technologies Provider Representative through the Agency website under Contacts > Provider Contacts > Provider Enrollment. NOTE: In order to expedite the review process, please make sure to include a contact name and telephone number along with the original self-attestation form to: Gainwell Technologies, P.O. Box 241685, Montgomery, Alabama 36124. For additional help, contact the Gainwell Technologies Provider Assistance Center at 1-800-688-7989.

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 if provider is not enrolled.

Yes. If a provider has more than one location, each location must be enrolled utilizing the provider’s assigned National Provider Identifier (NPI) number. If a group consists of more than one physician, each physician must be enrolled utilizing the physician’s assigned NPI number. This number identifies the provider only and does not change if the provider changes jobs or locations.

In order for Gainwell Technologies to update providers’ files so that their claims can automatically crossover from Medicare to Medicaid, providers must submit, by fax or mail, a copy of their Medicare notification letter received when they become a Medicare provider to Gainwell Technologies’ Provider Enrollment Unit. The letter should contain the provider’s National Provider Identifier (NPI) number as well as secondary identifiers for all service locations. Once this letter is received, information will be updated and claims should begin to crossover. Gainwell Technologies' fax number is (334) 215-4298.

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.

Physicians are required to register their Drug Enforcement Administration (DEA) number with the U.S. Department of Justice (DOJ) and have a copy on file with Medicaid. Medicaid will deny any claim for a controlled drug written by a prescriber who does not have their DEA number registered. To confirm if your DEA number is appropriately registered with the DOJ, and to ensure your correct address/contact information is registered with the DOJ, you may call the Department of Justice Registration Number Toll Free: (888) 514-7302 or (888) 514-8051. Prescribers of controlled substances are mandated to re-register their DEA license every three years.