Provider Enrollment and Forms

At the onset of the COVID-19 pandemic, Medicaid temporarily ceased revalidation for providers. Medicaid has now resumed revalidation for providers.  Affected providers may contact the Gainwell Provider Enrollment Unit at 1-888-223-3630 and speak to a Provider Enrollment Specialist.  To learn more about the revalidation process please scroll to the bottom of this page.

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.

ACHN Providers are required to complete agreement with both Medicaid and the ACHN in order to receive bonus and participation rates. Visit Forms for Provider Enrollment and Revalidation for ACHN and Primary Care Physicians (PCP) enrollment agreements.

Provider Enrollment Contact Information:
Enrolling as a Medicaid Provider
Fingerprint-Based Criminal Background Check Information

Federal requirements mandate providers revalidate periodically with the Alabama Medicaid program. Providers will be notified when they are scheduled for revalidation. Failure to revalidate 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 revalidate, providers will have to submit a new application for enrollment.