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Alabama Technical Considerations Fore Review (Bill Screening) of Claims

State:
Alabama
Control #:
AL-035-WC
Format:
PDF
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Description

Technical Considerations Fore Review (Bill Screening) of Claims Alabama Technical Considerations Fore Review (Bill Screening) of Claims is a process used by the Alabama Medicaid Agency to determine whether Medicaid will pay for a service or item. This process is used to ensure that claims submitted are in compliance with Medicaid laws and regulations. The review includes a thorough evaluation of all the technical requirements for coverage and payment, such as documentation, coding, and medical necessity. The review also includes a financial review to ensure that the cost of the item or service is reasonable. There are two types of Alabama Technical Considerations Fore Review (Bill Screening) of Claims: Prepayment Review and Post-payment Review. Prepayment Review is conducted prior to the payment of a Medicaid claim. It includes the review of documentation and coding, as well as a review of the medical necessity of the service or item. Post-payment Review is conducted after the payment of a Medicaid claim. It consists of a review of the accuracy of documentation and coding, as well as a review of the medical necessity and financial appropriateness of the service or item.

Alabama Technical Considerations Fore Review (Bill Screening) of Claims is a process used by the Alabama Medicaid Agency to determine whether Medicaid will pay for a service or item. This process is used to ensure that claims submitted are in compliance with Medicaid laws and regulations. The review includes a thorough evaluation of all the technical requirements for coverage and payment, such as documentation, coding, and medical necessity. The review also includes a financial review to ensure that the cost of the item or service is reasonable. There are two types of Alabama Technical Considerations Fore Review (Bill Screening) of Claims: Prepayment Review and Post-payment Review. Prepayment Review is conducted prior to the payment of a Medicaid claim. It includes the review of documentation and coding, as well as a review of the medical necessity of the service or item. Post-payment Review is conducted after the payment of a Medicaid claim. It consists of a review of the accuracy of documentation and coding, as well as a review of the medical necessity and financial appropriateness of the service or item.

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Alabama Technical Considerations Fore Review (Bill Screening) of Claims