Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-20 - THIRD PARTY
Section 560-X-20-.03 - Identification Of Third Party Resources

(1) The Claim - All providers are required to question Medicaid recipients to obtain information about third party resources which may pay for medical services provided to the recipient. All providers must complete third party fields on the Medicaid claim as required in the Alabama Medicaid Provider billing Manual.

(2) Refunds - All third party payments must be applied toward services for which payment was made. These payments may not be applied against other unpaid accounts. If providers receive duplicate payments from a third party and Medicaid, all duplicate party payments must be refunded within 60 days by:

(3) The Policy File - The Third Party Division, Medicaid, maintains a Policy File which identifies specific coverage provided by a recipient's health insurance. Under limited circumstances good cause may be indicated so that other insurance is not filed.

(4) Eligibility Verification - Third party benefit data is available for inquiry by providers through various resources. Providers should access available systems for third party health insurance information prior to filing Medicaid.