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Alabama Medicaid Agency

Our work advances healthcare and improves health for people in Alabama through our expertise in utilization management and quality review. From our Birmingham office, we collaborate with the Alabama Medicaid Agency (AMA). Our staff is composed of Alabamians who provide services within their own community to support the needs of Alabama residents. We are privileged to provide this vital work for the state of Alabama.

Services We Provide for the AMA

Our current work in Alabama includes medical and quality review for the AMA for the following healthcare services, equipment and supplies provided to Medicaid recipients:

  • Hospice reviews, including admission and concurrent review
  • Institutional admission review, including review of nursing homes, post-extended care, swing beds and inpatient psychiatric facilities
  • Prior authorization review, including review of durable medical equipment, home health, transportation, occupational and physical therapy, surgical procedures and inpatient and outpatient hospital services
  • Appeal review, including informal review and fair hearings


January 3, 2019: Annual Survey
It’s that time again! We are requesting your feedback through our annual Provider Satisfaction Survey.

Surveys will be sent mid-January. If you do not receive a related email or letter, email Judy Sarafin to request access.

Please take a few moments to complete the survey. We rely on your anonymous feedback to help us improve our processes and ensure that we are providing top-notch customer service. Thanks for your input!

Five lucky people who complete the survey by February 15 will each win a $20 Starbucks gift card. (Our survey contractor will conduct the drawing; the names of the winners will not be forwarded to Qualis Health.)

April 2014: We have created a provider manual for inpatient hospital quality assurance. You can also find it on the Provider Resources page.

As of November 1, 2013, Qualis Health has begun a new scope of work with the Alabama Medicaid Agency for hospital inpatient quality reviews. 

In January 2014, Qualis Health will send requests for medical record documentation for quarterly retrospective reviews of inpatient admissions. The first review timeframe will cover dates of service from April 1, 2013, through June 30, 2013, and July 1, 2013, through September 30, 2013.

We will also send requests for your Hospital Utilization Review Plan (UR Plan) and Medical Care Evaluation (MCE) study.

Contact Us

(888) 213-7576

(888) 213-8548

Contact the Alabama Medicaid Agency

Medicaid Providers Helpline:
(800) 688-7989

»visit the AMA website

»more contact info