To: All DME Providers, Dental Providers, Ambulance Providers, Inpatient Psychiatric Facilities, Physicians and Private Duty Nursing Providers

1 - Required use of Medicaid recipient ID numbers

Effective immediately, Alabama Medicaid providers must submit a valid Medicaid Recipient ID number in order to process and approve any prior authorization requests. EDS will return all requests that do not contain a valid number. Current Recipient ID numbers contain 13 digits, start with a “5” and do not contain the recipient’s Social Security number.

2 - Required use of Form 342A - DME PROVIDERS

Effective April 1, Medicaid providers must complete and submit Form 342A in addition to Form 342 when requesting prior authorization for durable medical equipment, supplies and appliances. Incomplete forms will be returned to the provider.

Providers should complete those sections of Form 342A specifically related to the PA request. The form will assist with meeting documentation requirements for the approval of prior authorization requests.

The form is available on the Agency’s website at http://www.medicaid.alabama.gov/billing/prior_authorization.aspx?tab=6

Questions regarding these requirements should be directed to Nancy Headley, Associate Director, Prior Authorization at (334) 242-5684 or by email at nancy.headley@medicaid.alabama.gov