PDF Version

TO:  All Dental Providers

RE:  Enhancement to Dental Administrative Review of Claims Process

Effective April 15, 2024, Dental providers who wish to submit denied dental claims for Administrative Review may begin using the Dental Administrative Review Form from the Forms menu on the Alabama Medicaid Interactive Web Portal.

The new form allows providers to submit Dental Administrative Review requests and supporting documentation for denied dental claims. Supporting documentation can be submitted by uploading documents in PDF format,  using a fax barcode cover sheet generated after form submission, or using the digital upload form located on the Alabama Medicaid Interactive Web Portal. Once the Dental Administrative Review form has been completed, a claim referencing the documentation can be submitted electronically for review.

Detailed instructions for submitting a Dental Administrative Review Form are available on the Agency website. This resource is available at www.Medicaid.Alabama.gov. Select the Programs tab, Dental Program, and look under the title, “Dental Forms.”

Providers may continue to utilize the current process described in Chapter 7 - Understanding Your Rights and Responsibilities as a Provider through August 1, 2024. Administrative Reviews received by mail on and after this date will be returned to providers.

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2024 American Medical Association and © 2024 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.