September 25, 2018

State of Alabama
Press Release: Medicaid

Individual AMHP Enrollment Requirements


PDF Version

 

TO:    All Psychologists, LPCs, ALCs, LMFTs, LMSWs, and LICSWs

 

RE:     Individual AMHP Enrollment Requirements

 


Provider enrollment requirements for LPCs, ALCs, LMFTs, LMSWs, and LICSWs

 

Beginning April 1, 2019, LPCs, ALCs, LMFTs, LMSWs and LICSWs must be an individually enrolled Medicaid provider and file claims using their own NPI number. Claims filed using the current method of using the psychologists’ NPI number will deny. 

 

To facilitate this transition, Medicaid will begin enrolling LPCs, ALCs, LMFTs, LMSWs, and LICSWs with their own NPI numbers as Medicaid providers starting October 1, 2018.  This enrollment must be completed prior to March 31, 2019. To allow providers adequate time to complete the enrollment process, Medicaid will allow providers to continue billing using modifiers U6, U7 and AJ through March 31, 2019

 

What steps are necessary to enroll?

 

1. Visit http://www.medicaid.alabama.gov/content/10.0_Contact/10.3_Provider_Contacts/10.3.4_Provider_Enrollment.aspx to complete a provider enrollment application. Providers associated with more than one group, or seeing patients at multiple locations, must submit a separate application for each location where services are rendered.  The enrollment process can take up to 40 days to complete and providers are encouraged to begin the enrollment process as soon as possible to prevent delays in payment.  All information on the enrollment application must be complete and accurate to be approved.

 

2.    Submit claims with the individual provider NPI number and discontinue billing using the psychologist’s NPI and appropriate modifier. 

 

Site Visits:

 

Please note that an unannounced site visit may be required as part of the enrollment process. Site visits are unscheduled, unannounced visits conducted by DXC Provider Representatives. DXC Provider Representatives, will wear a name badge with picture identification and provide a DXC business card at the time of visit.  If you are selected for a visit, please take a few moments to answer the questions and provide the additional documentation needed. 

 

Medicaid will review and verify claims through a post payment review process to ensure claims meet necessary requirements for a provider enrolled as LPC, ALC, LMFT, LMSW and LICSW. Claims that do not meet requirements may be subject to recoupment.        

 

Whom should a provider contact for further information?

 

1.      Enrollment questions should be directed to DXC provider enrollment at 1-888-223-3630 and select Option 2. 

 

2.     Billing questions should be directed to DXC, please visit: http://medicaid.alabama.gov/content/10.0_Contact/10.3_Provider_Contacts/10.3.5_Provider_Reps.aspx

 

3.      Contact Medicaid for policy related questions at karen.watkins-smith@medicaid.alabama.gov or  stephanie.logan@medicaid.alabama.gov





  • For more information, visit http://medicaid.alabama.gov
  • For more state-wide press releases, click here