PDF Version

To:  Providers using the Digital Upload Form

Re:  Changes to Digital Upload of Supporting Documentation

Effective April 15, 2024, Administrative Review (Dental ONLY) form type will be added to the dropdown on the Digital Upload form located on the Provider Secure Web Portal.

The Provider Secure Web Portal allows users to digitally upload additional supporting documentation for the following form types: Administrative Review (Dental ONLY), Consent, Third Party Liability Claims, Prior Authorization, Prior Authorization Reconsideration.

After initial submission of one of the above form types, providers may submit additional supporting documentation using the Digital Upload form which can be accessed within the Alabama Medicaid Interactive Web Portal.:

https://www.medicaid.alabamaservices.org/ALPortal/.

• On the Trade Files tab, select Forms.
• In the Form Name dropdown list, select DIG - Digital Upload and click Search.

To complete the form, the following information is required:

• Record ID (from initial form submission)
• Form Type
• PA or ICN or CA Number or ACN (from initial form submission)

Attachments being submitted must be in PDF format.

Once submitted, the supporting documentation will be added to the original form submission.

Note:

Providers with questions concerning the upload of supporting documentation should contact their Provider Representative. Contact information may be found at the following link:

http://medicaid.alabama.gov/content/10.0_Contact/10.3_Provider_Contacts/10.3.5_Provider_Reps.aspx.

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.