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.