Thursday, June 17, 2010

Medicaid Enrollment - Anesthesiology

Anesthesiology - Medicaid

Administration of anesthesia is a covered service when administered by or directed by a duly licensed physician for a medical procedure that is covered by Medicaid.

Enrollment

EDS enrolls anesthesiologists, Certified Registered Nurse Anesthetists (CRNA) and Anesthesiology Assistants (AA) and issues provider contracts to applicants who meet the licensure and/or certification requirements of the state of Alabama, the Code of Federal Regulations, the Alabama Medicaid Agency Administrative Code, and the Alabama Medicaid Provider Manual.

EDS also enrolls Certified Registered Nurse Anesthetists (CRNA), and Anesthesiology Assistants (AA) who are employed by a Medicaid enrolled physician or hospital.

National Provider Identifier, Type, and Specialty

A provider who contracts with Alabama Medicaid as an anesthesiologist, CRNA, or AA provider is added to the Medicaid systems with the NPIs provided at the time application is made. Appropriate specialty codes are assigned to enable the provider to submit requests and receive reimbursements for anesthesia-related claims.

Note : The 10 - digit NPI is required when filing a claim.

Anesthesiologists are assigned a provider type of 31 (Physician). CRNAs and AAs are assigned a provider type of 09(Anesthesiology). Valid specialties for the above include the following:
• Anesthesiology (311)
• Anesthesiology Assistant (1 01)
• CRNA (094)

Enrollment Policy for Anesthesiology Providers

Providers (in-state and out-of-state) who meet enrollment requirements are eligible to participate in the Alabama Medicaid Program.
In addition to the completed application, the following information for Anesthesiologist Assistants must be submitted and approved before the enrollment process can be initiated:
• Copy of current state license
• Copy of current certifications (CRNA or AA)

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