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 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.

Attorneys and insurance companies may utilize HMS’s online service 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 create their own 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.

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

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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