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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
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For help enrolling as a Medicaid provider, contact 1(888) 223-3630 or (334) 215-0111.
Who is eligible for Alabama Medicaid? Household Size*Maximum Income Level (Per Year)1$19,3922$26,2283$33,0644$39,9004 more rows
Medicaid patients get medical care from a variety of sources. Covered medical services include dental, eye and hearing care, lab and x-ray services as well as renal dialysis and transplant coverage.
For help enrolling as a Medicaid provider, contact 1(888) 223-3630 or (334) 215-0111.
How is Alabama Medicaid funded? Medicaid is funded jointly by the state and federal government. Medicaid's matching rate is approximately 70 percent federal, 30 percent state.
Prior authorization and other forms are available below. For questions related to prior authorization or overrides, contact KEPRO at 1-800-748-0130.
Contact Provider Enrollment at 1-888-223-3630 or visit the Provider Enrollment page of the Medicaid website, .medicaid.alabama.gov, under the Providers tab for instructions and forms to enroll.