Benefit Recovery/Subrogation Claims

Under Federal Law, Medicaid must seek the recovery of funds spent on a recipient’s medical care from any liable third party. When a Medicaid recipient receives treatment for an injury or is involved in a tort settlement, Medicaid’s Third Party Liability Division looks to identify any primary payment source. Potential sources include homeowners, automobile and other liability insurance as well as court-ordered restitution.

The Alabama Medicaid Agency has contracted with Health Management Systems (HMS) to enforce the Agency’s right to recovery in subrogation claims and requests for medical records. HMS performs the evaluation and case tracking functions of all casualty and litigation cases for Alabama Medicaid. HMS can be reached at 877-252-8949.

SOLARIS is HMS’s online service for existing cases. Attorneys and insurance companies may utilize HMS’s online service SOLARIS which is found at the link https://submissions.hms.com and may select either Request Claim/Lien Amount Personal Injury (CRUISE) or Submit Case Documents (IDOCs) from the drop down menu.

Users can access existing cases and directly upload other case documentation, including HIPAA-compliant Medical Authorizations. Requests for Compromise Forms and completed Compromise Forms can be submitted via the web portal. Additionally, the following documentation can be submitted for existing cases via the web portal at: https://submissions.hms.com. 

• Case Information Form

• HIPAA-compliant Authorization Form

• Settlement Documents

• Compromise Request Forms

INTRODUCING SOLARIS PLUS – A NEW SERVICE FOR NEW REFERRALS: 

SOLARIS PLUS is HMS’s online service for new referrals.  SOLARIS PLUS, which is found at https://solarisplus.hms.com, provides users with a more transparent view of their cases with increased functionality:

• Create New Cases

• Submit or Route Medical Authorizations to Clients Via DocuSign

• Request Information

• Upload Documents

• Review Claims

• Request Compromises

• Submit Claim Disputes

• Obtain Claim/Lien Amounts

For assistance, contact HMS at 877-252-8949. 

If at any point your submission is unsuccessful through the web portal, please print the error page, attach it to your letter of representation and send it to alcasualty@hms.com. 

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