Alabama Procedure For Pre-Certification

State:
Alabama
Control #:
AL-033-WC
Format:
PDF
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Description

Procedure For Pre-Certification

Alabama Procedure For Recertification is a process that is used to make sure that medical services meet the necessary criteria for reimbursement. It is a way for health care providers to get prior approval for certain medical services. There are three types of Alabama Procedure For Recertification: 1. Recertification for Inpatient Services: This is required for all inpatient services, including medical, surgical, and inpatient mental health services. It involves submitting a request for recertification through the Recertification system, which is reviewed by a Medical Reviewer. If approved, the provider will be issued a Recertification number. 2. Recertification for Outpatient Services: This is required for all outpatient services, including medical, surgical, and outpatient mental health services. The provider must submit a request for recertification through the Recertification system, which is reviewed by a Medical Reviewer. If approved, the provider will be issued a Recertification number. 3. Recertification for High-Risk Services: This is required for specific high-risk services, such as certain procedures and surgeries that require additional review prior to approval. The provider must submit a request for recertification through the Recertification system, which is reviewed by a Medical Reviewer. If approved, the provider will be issued a Recertification number. Once the Recertification number has been issued, the provider can then submit claims for reimbursement.

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Alabama Procedure For Pre-Certification