August 29, 2014

State of Alabama
Press Release: Medicaid

Alabama Medicaid Cardiology Prior Authorization Program Effective October 1, 2014

Click here to print a PDF version

 

TO:  Physicians, Hospitals, Rural Health Clinics, FQHC’s, and Health Departments


Beginning October 1, 2014, CareCore National, LLC (CareCore) will implement the Alabama Medicaid Agency prior authorization (PA) program for Cardiology procedures listed below:

 

1.    Nuclear Cardiology – 78451, 78452, 78453, 78454

2.    Diagnostic Heart Catheterization – 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, 93461

3.    Stress Echocardiography – 93350, 93351

4.    Transesophageal Echo – 93312, 93313, 93314

5.    Transthoracic Echo – 93303, 93304, 93306, 93307, 93308

 

Any of the procedures specified above will require a PA from CareCore.  Information will be accepted

(i.e., online submissions, or via telephone) beginning September 15, 2014, for services scheduled to be rendered on or after October 1, 2014.

 

The PA requirements will apply to the following Medicaid recipients:

 

1.    SOBRA Children

2.    Parents and Other Caretaker Relatives (POCR) Program, formerly, Medicaid for Low Income Families Program

3.    Refugees, or

4.    Supplemental Security Income

 

Please note that no PA is required for the following:

 

1.    Medicare patients

2.    Cardiology services performed as an inpatient hospital service, or

3.    Cardiology services performed as an emergency room service

 

This Program is applicable to services provided in the following settings:

 

1.    Freestanding imaging facilities

2.    Hospital outpatient facilities

3.    Physician offices

4.    Public Health Clinics

5.    Rural Health Clinics

6.    Federally Qualified Health Clinics

 

Physicians may request a PA by contacting CareCore using one of the following methods:

 

1.    Telephone (Alabama Medicaid) 1-855-774-1318, or

2.    Online: www.carecorenational.com


Training Available:

CareCore will provide a training webinar on September 9, 2014, 11 a.m. – 12 p.m. CDT, and September 11, 2014, 12 p.m. – 1 p.m. CDT, to help you learn more about our program.  The webinars will address the scope of the cardiology PA process; provide guidance on obtaining a PA, and answer providers’ questions.  The webinar link will be transmitted to providers on September 5, 2014.  To learn more, please visit the Tools and Criteria Page at: www.carecorenational.com.  You may find additional information about CareCore, and their policies, procedures, and plan specific information you and your staff will need to participate in the program on their website at: www.carecorenational.com.  Providers may register on-line to set up an account to use CareCore’s web site to submit PA requests.

 

09/09/2014 Alabama Medicaid Webinar meeting information

Topic: State of Alabama prior authorization information session

Date: Tuesday, September 9, 2014

Time: 11:00 pm, Central Daylight Time

Meeting Number: 733 500 473

Meeting Password: webex123


To start or join the online meeting go to: https://carecorenational.webex.com/carecorenational/j.php?MTID=mf3ef0ca74b1a11040f88e9aeac583fe2

Audio conference information
To receive a call back, provide your phone number when you join the meeting, or call the number below and enter the access code.
Call-in toll-free number (US/Canada): 1-877-668-4493
Call-in toll number (US/Canada): 1-650-479-3208
Global call-in numbers:
https://carecorenational.webex.com/carecorenational/globalcallin.php?serviceType=MC&ED=314247662&tollFree=1
Toll-free dialing restrictions:
http://www.webex.com/pdf/tollfree_restrictions.pdf

 

Access code: 733 500 473

 

For assistance:

1. Go to https://carecorenational.webex.com/carecorenational/mc
2. On the left navigation bar, click "Support".

To check whether you have the appropriate players installed for UCF (Universal Communications Format) rich media files, go to https://carecorenational.webex.com/carecorenational/systemdiagnosis.php.
http://www.webex.com    CCM: +16504793208x733500473#

IMPORTANT NOTICE: This WebEx service includes a feature that allows audio and any documents and other materials exchanged or viewed during the session to be recorded. You should inform all meeting attendees prior to recording if you intend to record the meeting. Please note that any such recordings may be subject to discovery in the event of litigation.

09/11/2014 Alabama Medicaid Webinar meeting information

Topic: State of Alabama prior authorization information session
Date: Thursday, September 11, 2014
Time: 12:00 pm, Central Daylight Time
Meeting Number: 735 153 026
Meeting Password: webex123

To start or join the online meeting go to: https://carecorenational.webex.com/carecorenational/j.php?MTID=m453af19a342ead828455c3b411421d8e

Audio conference information
To receive a call back, provide your phone number when you join the meeting, or call the number below and enter the access code.
Call-in toll-free number (US/Canada): 1-877-668-4493
Call-in toll number (US/Canada): 1-650-479-3208
Global call-in numbers: https://carecorenational.webex.com/carecorenational/globalcallin.php?serviceType=MC&ED=314249117&tollFree=1
Toll-free dialing restrictions: http://www.webex.com/pdf/tollfree_restrictions.pdf

Access code: 735 153 026

For assistance
1. Go to https://carecorenational.webex.com/carecorenational/mc
2. On the left navigation bar, click "Support".

 

To check whether you have the appropriate players installed for UCF (Universal Communications Format) rich media files, go to https://carecorenational.webex.com/carecorenational/systemdiagnosis.php.
http://www.webex.com    CCM: +16504793208x735153026#

IMPORTANT NOTICE: This WebEx service includes a feature that allows audio and any documents and other materials exchanged or viewed during the session to be recorded. You should inform all meeting attendees prior to recording if you intend to record the meeting. Please note that any such recordings may be subject to discovery in the event of litigation.

 

 

Questions:

Frequently Asked Question (FAQ) are available on CareCore’s website, along with a complete list of Cardiology procedures at: www.carecorenational.com.  You may also telephone CareCore at 1-800-918-8924, and then choose option “2”.

 

Providers with additional questions may contact Russell Green, Associate Director, Medical Services Division, at (334) 353-4783.

 

 

 



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