Get the free Alabama Medicaid Hospital Subpart Enrollment Application

This document serves as an application form for hospitals to enroll their subparts with Alabama Medicaid, detailing the necessary information and guidelines for the enrollment process.

How to fill out alabama medicaid hospital subpart

How to fill out Alabama Medicaid Hospital Subpart Enrollment Application

1. Gather all necessary documents, including your hospital's federal tax identification number, NPI (National Provider Identifier), and any licensing information.
2. Complete the Alabama Medicaid Hospital Subpart Enrollment Application form, ensuring all sections are filled out accurately.
3. Provide detailed information about the subpart services offered, including patient capacity and types of services.
4. Indicate whether the hospital subpart is affiliated with a larger hospital and provide details as required.
5. Review the application for accuracy and completeness before submission.
6. Submit the application along with all required documentation through the specified submission method indicated in the guidelines.
7. Retain a copy of the submitted application and documents for your records.
8. Follow up with Alabama Medicaid to confirm receipt of your application and inquire about the approval timeline.

Who needs Alabama Medicaid Hospital Subpart Enrollment Application?

1. Hospitals that wish to provide outpatient or specialty services under Alabama Medicaid.
2. Healthcare organizations that are independent or part of a larger hospital system.
3. Any facility that seeks reimbursement for services provided to Medicaid recipients.

People Also Ask about

What is the maximum income to qualify for Medicaid in Alabama?

1:08 2:11 They've got the final say on who gets to join the Medicaid. Roundup. To learn more check out theseMoreThey've got the final say on who gets to join the Medicaid. Roundup. To learn more check out these links which you can click in the description.

What is the income limit to qualify for Medicaid in Alabama?

Income after deductions cannot exceed $3,243 per month for a family of 3. Income after deductions cannot exceed $3,912 per month for a family of 4. Parent and Caretaker Relatives:* Income after deductions cannot exceed $235 per month for a family of 1.

What is documentation required for Medicaid in Alabama?

Below is a partial listing of some goods and services that are not covered by Medicaid in Alabama. Medicaid will NOT pay for: • Cosmetic surgery or procedures. partials, dentures or bridgework, gold caps or crowns, or periodontal or gum surgery. Hearing services for adults (age 21 and older).

What documentation is required for Medicaid in Alabama?

1:08 2:11 They've got the final say on who gets to join the Medicaid. Roundup. To learn more check out theseMoreThey've got the final say on who gets to join the Medicaid. Roundup. To learn more check out these links which you can click in the description.

Which of the following documents must an applicant provide to be Medicaid eligible?

Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s. A verification of what other government benefits you receive. Information about an insurance plan your employer has offered you or an insurance plan you currently have.

What paperwork do you need for Medicaid?

Preparing to Apply for Medicaid Proof of identity (driver's license, birth certificate, passport) Social Security numbers for all applicants. Proof of income (pay stubs, tax returns, benefit statements) Proof of residency (utility bill, lease agreement, mortgage statement)

How do I enroll as a provider for Medicaid in Alabama?

A variety of online and paper forms are available to providers wishing to enroll or revalidate. For help enrolling as a Medicaid provider, contact 1(888) 223-3630 or (334) 215-0111.

For pdfFiller’s FAQs

What is Alabama Medicaid Hospital Subpart Enrollment Application?

The Alabama Medicaid Hospital Subpart Enrollment Application is a form used by hospitals to enroll their subparts, such as distinct units or departments, in the Alabama Medicaid program to receive Medicaid reimbursements.

Who is required to file Alabama Medicaid Hospital Subpart Enrollment Application?

Hospitals that wish to enroll subparts for Medicaid reimbursement must file the Alabama Medicaid Hospital Subpart Enrollment Application. This typically includes facilities that operate distinct units that provide inpatient or outpatient care.

How to fill out Alabama Medicaid Hospital Subpart Enrollment Application?

To fill out the Alabama Medicaid Hospital Subpart Enrollment Application, applicants must provide detailed information about the subpart, including its name, location, services offered, and designation in relation to the main hospital, accurate documentation of the hospital's operational status, and any other relevant details as requested on the form.

What is the purpose of Alabama Medicaid Hospital Subpart Enrollment Application?

The purpose of the Alabama Medicaid Hospital Subpart Enrollment Application is to ensure that hospital subparts are duly recognized and enrolled in the state's Medicaid program so they can offer services to Medicaid beneficiaries and receive appropriate reimbursement for those services.

What information must be reported on Alabama Medicaid Hospital Subpart Enrollment Application?

The application must report information such as the subpart's name, address, type of services offered, the main hospital's identifying information, ownership details, and certification status, along with any other specifics required by the Alabama Medicaid Agency.