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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.