Alabama Medicaid — Alabama Medicaid (FFS + Alabama Coordinated Health Network)
| Program name | Alabama Medicaid (FFS + Alabama Coordinated Health Network) |
|---|---|
| Provider portal | https://medicaid.alabama.gov |
| FFS claims payer ID | No single canonical ID — routing is fiscal-intermediary-specific. Verify per clearinghouse. |
| Medicaid timely filing | 365 days from date of service |
The federal ceiling for Medicaid timely filing is 12 months under 42 CFR §447.45; most states set a shorter window. Always verify the current policy on the Alabama Medicaid provider portal before filing a late-billing appeal.
BCBS licensee in Alabama
The Blue Cross Blue Shield Association licensee in Alabama is Blue Cross and Blue Shield of Alabama. See the BCBS Alabama payer guide for payer ID, timely filing, prior auth, and appeal procedures.
Top commercial payers in Alabama
The dominant commercial insurers operating in Alabama, in approximate order of lives covered. Click through for per-payer claims payer IDs, timely filing windows, prior-authorization rules, and appeal procedures.
Medicaid MCOs in Alabama
Alabama Medicaid MCO data has not yet been populated in the registry.
Medicare contractor and active LCDs in Alabama
Palmetto GBA is the Medicare A/B MAC for Alabama: Part A and Part B fee-for-service claims from Alabama go to it, and its Local Coverage Determinations decide local medical necessity. Durable medical equipment and supply claims go to CGS Administrators, LLC as the DME MAC. Home health and hospice claims are processed by Palmetto GBA. In the current Medicare Coverage Database export, 247 active LCDs from these contractors apply to Alabama claims.
- Palmetto GBA
A/B MAC (Part A and Part B claims); Home health and hospice MAC
- CGS Administrators, LLC
DME MAC (durable medical equipment and supplies)
Selected active Palmetto GBA policies for Alabama
A selection, not the full list: policies with measured search demand come first, then those on topics that more contractors publish LCDs for.
- L35025 MolDX: Molecular Diagnostic Tests (MDT)
- L37379 Echocardiography
- L39671 Trigger Point Injections (TPI)
- L34415 CT of the Abdomen and Pelvis
- L39853 Outpatient Psychotherapy
- L35724 Urine Drug Testing
- L38779 MolDX: Minimal Residual Disease Testing for Cancer
- L39237 Erythropoiesis Stimulating Agents
- L33445 Removal of Benign and Malignant Skin Lesions
- L33459 Computerized Axial Tomography (CT), Thorax
- L38765 Facet Joint Interventions for Pain Management
- L37794 MolDX: Breast Cancer Index® (BCI) Gene Expression Test
Equipment, home health and hospice policies that apply in Alabama
- L33822 Glucose Monitors
- L33789 Power Mobility Devices
- L33318 Knee Orthoses
- L33686 Ankle-Foot/Knee-Ankle-Foot Orthosis
- L33718 Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- L34544 Hospice - Liver Disease
- L34547 Hospice - Neurological Conditions
- L34548 Hospice Cardiopulmonary Conditions
Steps to confirm which LCD governs a claim · Every active LCD by contractor
State-specific regulations affecting Alabama billing
- Ala. Code §27-1-17 (prompt pay — 45 days clean claim, 1% per month interest)
- Ala. Admin Code 560-X-15-.06 (Medicaid timely filing)
- Ala. Code §22-21-290 (hospital financial assistance)
Provider licensing & enrollment in Alabama
Providers enroll via Alabama Medicaid Interactive Services Center (ISC) operated by DXC Technology. ACHN participation requires separate attestation.
Major health systems headquartered in Alabama
| Health system | Headquarters |
|---|---|
| UAB Medicine (University of Alabama at Birmingham Health System) | Birmingham, AL |
| Infirmary Health | Mobile, AL |
| Huntsville Hospital Health System | Huntsville, AL |
| USA Health (University of South Alabama) | Mobile, AL |
| Baptist Health (Montgomery) | Montgomery, AL |
Frequently asked questions — Alabama billing
What is the Alabama Medicaid program called?
Alabama's Medicaid program is known as Alabama Medicaid (FFS + Alabama Coordinated Health Network). Providers enroll and manage claims through the provider portal at https://medicaid.alabama.gov.
What is the Alabama Medicaid timely filing limit?
Alabama Medicaid (FFS + Alabama Coordinated Health Network) requires initial claims to be filed within 365 days from the date of service. The federal ceiling is 12 months under 42 CFR §447.45; Alabama's 365-day window is set by the state provider manual. Late-billing exceptions may be allowed with good-cause documentation — verify on the state portal before filing an appeal.
Does Alabama Medicaid publish a single claims payer ID?
No single canonical claims payer ID is published for Alabama Medicaid (FFS + Alabama Coordinated Health Network). Claims route through the state's fiscal intermediary; look up the correct submitter ID in your clearinghouse directory (Availity, Change Healthcare/Optum, Waystar) and route managed-care claims by the member's MCO assignment.
Who are the largest commercial insurers in Alabama?
The dominant commercial payers in Alabama include BCBS Alabama, UnitedHealthcare, Aetna, Cigna, Humana, along with the BCBS licensee Blue Cross and Blue Shield of Alabama. Each payer's claims routing, timely filing, and prior-auth rules differ — see the per-payer guides linked above.
What Medicaid managed-care organizations operate in Alabama?
Alabama Medicaid MCO data has not yet been populated in the registry. Consult the state Medicaid portal for the current MCO roster.
What state-specific billing regulations apply in Alabama?
Alabama has 3 tracked state-level statutes that affect medical billing and RCM: Ala. Code §27-1-17 (prompt pay — 45 days clean claim, 1% per month interest); Ala. Admin Code 560-X-15-.06 (Medicaid timely filing); Ala. Code §22-21-290 (hospital financial assistance). These sit on top of federal protections such as the No Surprises Act, HIPAA, and 42 CFR §447.45.
Run cleaner claims in Alabama with QuickIntell
QuickRCM, QuickAuth, and QuickERA are tuned to Alabama Medicaid (FFS + Alabama Coordinated Health Network) and the commercial payers on this page — eligibility, prior auth, claim scrubbing, and ERA posting all run on real payer rules, not generic adapters.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. State Medicaid policies, MCO contracts, and payer rules change without notice — always verify against the current provider manual from Alabama Medicaid and the member ID card before submission.